Severe mitral regurgitation in horses: clinical, echocardiographic and pathological findings

Effects of the ACE Inhibitor Quinapril on Echocardiographic Variables in Horses with Mitral Valve Insufficiency

Twenty horses with mitral valve insufficiency, but without signs of congestive heart failure, and five horses without signs of heart disease were examined before and after medication with an angiotensin-converting enzyme (ACE) inhibitor. The examination included echocardiography assessment as well as heart catheterization. The echocardiographic examination included B-mode, M-mode, conventional and colour Doppler techniques. For 8 weeks, all horses were treated with Accupro 20 (active substance: Quinapril) at an oral dose rate of 120 mg/horse/day. A follow-up of the horses with mitral valve insufficiency after 8 weeks revealed a statistically significant increase in the stroke volume and the cardiac output as well as a decrease in regurgitation velocity time integral (VTI). The regurgitation blood velocity remained the same. The severity of mitral valve insufficiencies revealed a moderate improvement in five horses, from moderate to mild, after therapy. Significant changes of cardiac dimension (B-mode) and shortening fraction (M-mode) before and after treatment could not be observed. The owners' judgement of the horses' performance was that of a minor improvement. In the horses without clinical findings the results of examination before and after treatment remained the same.

Lower airway diseases of the adult horse

Lower airway problems of the adult horse are commonly encountered by the practitioner. Particularly susceptible populations include horses transported for any significant distance and young horses grouped together for training and/or competition. This article presents some of the commonly encountered problems of this patient population, including bacterial pneumonia/pleuropneumonia and influenza, and some uncommon ones, including pulmonary edema, pneumothorax/hemothorax, and acuterespiratory distress syndrome. Information is presented that should allow the practitioner to diagnose these problems accurately and initiate rational treatment plans.

Cardiac disease in the geriatric horse

Almost all equine cardiac diseases may affect the geriatric horse. This article focuses on those cardiac diseases that are most common in the older horse, including degenerative valve disease, aortocardiac fistula, and congestive heart failure. Other cardiac diseases, such as bacterial endocarditis, pericarditis, and arrhythmias, are seen in all age groups of horses and are beyond the scope of this article.

Two-dimensional and M-mode echocardiographic measurements of cardiac dimensions in healthy standardbred trotters

The aim of the study was to establish normal echocardiographic values of healthy Standardbred trotters not published previously. Twenty-three clinically normal horses weighing between 350 and 490 kg were examined in the same manner: first a thorough physical and then detailed echocardiographic examination were performed. Standardised two-dimensional (2D) and guided M-mode echocardiographic imaging techniques were used to measure interventricular septal thickness (IVS), left ventricular internal diameter (LVID), left ventricular wall thickness (LVW), left atrial internal diameter (LAID) in end-systole (s) and end-diastole (d) and aortic diameter (AOD) in end-diastole. Mean, range and standard deviation of the different parameters were calculated. The mean values (in centimetres) were as follow (2D/M-mode): IVSs: 4.6/4.7; IVSd: 3.1/3.0; LVIDs: 7.0/7.0; LVIDd: 10.7/10.7; LVWs: 3.9/3.9; LVWd: 2.7/2.7; LAIDs: 10.4/-; LAIDd: 11.3/-; AODd: 7.2/-. Results of two-dimensional and M-mode measurements were compared to each other and to normal values obtained from other breeds.

Congestive heart failure in horses: 14 cases (1984-2001)

OBJECTIVE

To identify clinical signs, underlying cardiac conditions, echocardiographic findings, and prognosis for horses with congestive heart failure.

DESIGN

Retrospective study.

ANIMALS

14 horses.

PROCEDURE

Signalment; history; clinical signs; clinicopathologic, echocardiographic, and radiographic findings; treatment; and outcome were determined by reviewing medical records.

RESULTS

All 14 horses were examined because of a heart murmur; tachycardia was identified in all 14. Twelve horses had echocardiographic evidence of enlargement of 1 or more chambers of the heart. Other common clinical findings included jugular distention or pulsation, crackles, cough, tachypnea, and ventral edema. Nine horses had signs consistent with heart failure for > 6 days. Underlying causes for heart failure included congenital defects, traumatic vascular rupture, pericarditis, pulmonary hypertension secondary to heaves, and valvular dysplasia. Seven horses were euthanatized after diagnosis of heart failure; 5 were discharged but were euthanatized or died of complications of heart disease within 1 year after discharge. The remaining 2 horses were discharged but lost to follow-up.

CONCLUSIONS AND CLINICAL RELEVANCE

Results suggest that congestive heart failure is rare in horses. A loud heart murmur accompanied by either jugular distention or pulsation, tachycardia, respiratory abnormalities (crackles, cough, tachypnea), and ventral edema were the most common clinical signs. Echocardiography was useful in determining the underlying cause in affected horses. The long-term prognosis for horses with congestive heart failure was grave.