Quadricuspid aortic valve and a ventricular septal defect in a horse.
Authors: Michlik Katarzyna M, Biazik Anna K, Henklewski Radomir Z, Szmigielska Marta A, Nicpoń Józef M, Pasławska Urszula
Journal: BMC veterinary research
Summary
# Editorial Summary: Quadricuspid Aortic Valve and Ventricular Septal Defect in an Equine Case Congenital cardiac defects remain relatively uncommon findings in equine practice, yet their clinical significance warrants awareness amongst veterinarians managing presurgical cases. A 5-year-old stallion presented for routine castration with audible cardiac murmurs—specifically a grade 5/6 pansystolic murmur accompanied by tachycardia, precordial thrill, and subcutaneous oedema—prompting echocardiographic investigation that revealed a previously undocumented combination of quadricuspid aortic valve (with one small, two equal-sized, and one large cusp) and a ventricular septal defect in the membranous septum. These defects were further complicated by mild aortic regurgitation and severe tricuspid regurgitation. Notably, the horse tolerated general anaesthesia and surgical castration without immediate complications, though clinical deterioration progressed over the subsequent 17 months, culminating in euthanasia due to weight loss, weakness and recumbency. This case highlights the importance of thorough cardiac auscultation and echocardiographic assessment during presurgical evaluations, as anaesthetic risk in horses with multiple valvular defects remains poorly characterised; equine practitioners should maintain heightened suspicion for concurrent congenital cardiac anomalies when abnormal cardiac findings are detected, particularly in younger animals.
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Practical Takeaways
- •Congenital cardiac defects may not prevent horses from undergoing necessary surgical procedures, but long-term prognosis remains poor with progressive clinical deterioration
- •Pre-surgical cardiac auscultation findings of significant murmurs warrant echocardiographic evaluation to characterize defects before anesthetic planning
- •Horses with combined congenital cardiac lesions require careful anesthetic management and realistic owner expectations regarding long-term survival and quality of life
Key Findings
- •First documented case in equine literature of quadricuspid aortic valve combined with ventricular septal defect in the membranous portion of the intraventricular septum
- •Five-year-old stallion presented with grade 5/6 pansystolic murmur, subcutaneous oedema, tachycardia, and precordial thrill on cardiac examination
- •Horse successfully tolerated surgical castration under general anesthesia despite severe cardiac defects, but developed progressive weight loss and weakness leading to euthanasia 17 months post-surgery