Outcome of horses diagnosed with and treated for heaves (recurrent airway obstruction)
Authors: Aviza G. A., Ainsworth D. M., Eicker S. W., Santiago M. A., Divers T. J., Perkins G. A.
Journal: Equine Veterinary Education
Summary
# Editorial Summary: Cor Pulmonale and Cardiac Complications in Equine Recurrent Airway Obstruction Whilst cor pulmonale (right-sided heart disease secondary to pulmonary hypertension) has long been recognised as a potential consequence of severe chronic lung disease in humans, its occurrence in horses with recurrent airway obstruction (RAO) remained largely undocumented until this case report. Aviza and colleagues describe a horse that presented with acute onset paroxysmal atrial fibrillation—an arrhythmia lasting two days—directly triggered by a severe RAO exacerbation, representing the first documented case of RAO-induced pulmonary hypertension causing atrial fibrillation in the equine literature. The clinical significance of this finding lies not in its frequency, but in demonstrating that even substantial cardiac remodelling secondary to respiratory dysfunction can reverse substantially with appropriate management, suggesting that aggressive treatment of acute RAO episodes may prevent irreversible cardiac damage. For practitioners managing horses with severe or poorly controlled RAO, this case underscores the importance of recognising atrial fibrillation as a potential emergency complication and highlights that cardiac involvement, whilst uncommon, warrants investigation in horses presenting with arrhythmias coinciding with respiratory crises. The reversibility of these changes offers prognostic optimism, provided respiratory control is restored promptly.
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Practical Takeaways
- •Recognize that severe heaves exacerbations can trigger life-threatening cardiac complications including cor pulmonale and arrhythmias—monitor respiratory cases closely for cardiac signs.
- •Be aware that even significant cardiac changes from respiratory disease may resolve with aggressive airway management, so aggressive treatment of severe RAO is justified even with concurrent cardiac involvement.
Key Findings
- •Severe RAO exacerbation resulted in cor pulmonale and paroxysmal atrial fibrillation lasting 2 days, representing the first reported case of RAO-induced pulmonary hypertension causing atrial fibrillation in horses.
- •Severe cardiac changes secondary to respiratory dysfunction were largely reversible following appropriate RAO treatment.