Horse diagnosed with heart defect after chronic coughing

Abstract

A partial atrioventricular septal defect, represented as a large ostium primum atrial septal defect and common (bridging) atrioventricular valve leaflets with cleft septal leaflet of the mitral valve, was diagnosed incidentally in a nine-year-old warmblood gelding used for show jumping. Initial examination findings and a three-year follow-up are documented in this report. The horse was first presented for the evaluation of chronic coughing. A left-sided, grade 4/6 holosystolic (band-shaped) murmur was identified along with a similar right-sided, grade 3/6 heart murmur. Echocardiography revealed a 6.4 cm diameter communication in the ventral atrial septum, considered an ostium primum atrial septal defect, with bidirectional shunting. A hypertrophic septomarginal trabecula, a thickened tricuspid valve, a cleft septal leaflet of the mitral valve, moderate mitral and tricuspid regurgitation likely related to leaflet prolapse, mild aortic regurgitation, and signs of moderate right ventricular volume overload were found as well. Electrocardiography showed no arrhythmias neither at rest nor during treadmill exercise. The owner continued to use the horse for show jumping. No exercise intolerance or other signs of disease were noted. Follow-up examination was performed three years after initial presentation. Contrast echocardiography confirmed the presence of right-to-left shunting through the atrial septal defect. Compared with the initial examination, the left ventricular internal diameter on M-mode echocardiography had increased. Occasional ventricular premature depolarizations were noted on the resting and exercise electrocardiogram. This is the first description of a clinically asymptomatic partial atrioventricular septal defect in an adult sport horse.