Quadricuspid aortic valve in a 16-year-old Quarter horse.
Authors: Caivano D, Cicogna M, Orvieto S, Spitale D, Porciello F
Journal: Journal of equine veterinary science
Summary
# Editorial Summary: Quadricuspid Aortic Valve in an Equine Patient Congenital cardiac abnormalities are uncommon in horses, making this case of a 16-year-old Quarter horse gelding with a quadricuspid aortic valve worthy of clinical attention. The gelding presented with a newly detected diastolic murmur and irregular pulse, prompting comprehensive cardiac investigation including electrocardiography and transthoracic echocardiography, which revealed an anatomically abnormal aortic valve consisting of four cusps (two larger equal cusps and two smaller unequal cusps) rather than the normal three. Colour flow Doppler imaging demonstrated central diastolic regurgitation through the malformed valve, confirming mild to moderate aortic insufficiency secondary to the structural defect. Although this horse had reached 16 years of age, the progressive nature of valvular disease means practitioners should maintain vigilance for haemodynamic changes and clinical deterioration, particularly during periods of increased cardiovascular demand. This case underscores the diagnostic value of echocardiography for identifying congenital cardiac anomalies that may evade detection on routine auscultation, and highlights the importance of investigating new or previously unreported cardiac murmurs in mature horses to establish baseline cardiac status and inform prognosis and management strategies.
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Practical Takeaways
- •Newly detected cardiac murmurs in adult horses warrant echocardiographic evaluation, as rare congenital defects may present later in life
- •Quadricuspid aortic valve is a rare but diagnosable congenital condition in horses; awareness of this anomaly helps clinicians recognize and classify similar presentations
- •Transthoracic echocardiography is essential for characterizing valve morphology and regurgitation severity in horses with suspected structural cardiac disease
Key Findings
- •A 16-year-old Quarter horse presented with a grade III/VI diastolic murmur and newly detected cardiac irregularity secondary to a rare congenital quadricuspid aortic valve
- •Echocardiography identified four aortic valve cusps (two equal larger and two unequal smaller cusps) with central diastolic regurgitant flow
- •Diagnosis was mild to moderate aortic valve insufficiency secondary to the quadricuspid valve morphology
- •Transthoracic echocardiography enabled detection and characterization of this rare congenital cardiac defect in an adult horse