Post-traumatic interventricular septal hematoma in a dog

Abstract

A six-year-old, neutered male, Airedale terrier with craniocerebral injury and shock after being hit by a car developed post-traumatic arrhythmia, which persisted after hemodynamic and neurological stabilization. Cardiac troponin I was markedly elevated. Transthoracic echocardiography and computed tomography angiography revealed an interventricular septal lesion, compatible with a myocardial splitting and intramural hematoma formation. The cardiac lesion resolved almost completely during the following weeks. About one year after initial presentation, the dog was referred with signs of right-sided congestive heart failure, thin and inhomogeneous interventricular septum, dilated cardiac chambers, and pulmonary artery, compatible with pulmonary hypertension, likely secondary to the left heart disease. Eventually the dog was euthanized due to poor response to medical therapy, approximately one year after his first decompensation. Interventricular septal hematomas are rare events in people, usually associated with cardiac surgery, trauma, or acute myocardial ischemia. This is the first dog described with a post-traumatic septal hematoma that has been extensively documented by means of echocardiography and cross-sectional imaging.