Peer-reviewed veterinary case report
Transthoracic echocardiography and its limitations in the diagnosis of congenital supernumerary aortic valve in a Thoroughbred.
- Journal:
- Veterinary medicine and science
- Year:
- 2023
- Authors:
- Vitale, Valentina et al.
- Affiliation:
- University Teaching Hospital · Australia
- Species:
- horse
Plain-English summary
This case report discusses a Thoroughbred horse that had a rare heart condition called a quadricuspid aortic valve, which means the valve had four flaps instead of the usual three. The horse was experiencing exercise intolerance, meaning it was having trouble keeping up during physical activity, and it also had a temporary heart rhythm issue called atrial fibrillation. The report emphasizes that while echocardiography (a type of ultrasound for the heart) can help identify heart problems, it has limitations and can sometimes lead to misdiagnosis. It also points out that congenital heart issues can exist without obvious symptoms, so screening even healthy-looking horses is important. The treatment and outcome for this specific case were not detailed, but the report aims to improve diagnosis in similar situations.
Abstract
Aortic valve malformation is a common congenital abnormality reported in human medicine. The malformation is characterised by an increased or decreased number of cusps. Anatomical variations of the aortic valve that have been documented in humans include unicuspid, bicuspid, quadricuspid and quinticuspid valves. Two reports described a quadricuspid aortic valve in horses associated with either a ventricular septal defect (VSD) or tetralogy of Fallot. In this case report we describe the clinical and echocardiographic findings of a horse with a quadricuspid aortic valve as single congenital abnormality, referred with history of exercise intolerance and an episode of paroxysmal atrial fibrillation. Limitations and risks of misdiagnosis that can be encountered with transthoracic echocardiography are also discussed. The reported case highlights the importance of echocardiographic screening in asymptomatic patients as congenital heart disease can be present without obvious cardiac signs. As advanced imaging on the equine thorax is still far from future possibilities for adult horses, this report may help to reach an accurate diagnosis with similar cases.
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Search related cases →Original publication: https://pubmed.ncbi.nlm.nih.gov/33713550/