Feasibility of the echocardiographic subcostal view in newborn foals: two-dimensional and Doppler aortic findings.
Authors: Freccero F, Cordella A, Dondi F, Castagnetti C, Niinistö K, Cipone M
Journal: Equine veterinary journal
Summary
# Editorial Summary Veterinarians performing cardiac assessments on newborn foals now have access to a superior imaging technique previously unexplored in equine practice. Researchers obtained echocardiographic images from 23 healthy Standardbred and Warmblood foals aged 7 hours to 6 days, acquiring measurements from both the conventional left parasternal long-axis view and a novel subcostal approach while foals lay in lateral recumbency. The subcostal view proved feasible in all animals and, critically, yielded significantly higher aortic velocity measurements than standard parasternal imaging—with maximal aortic velocities, velocity time integrals, and pressure gradients all substantially greater (P<0.0001, P=0.0001, and P<0.0001 respectively), with the most pronounced differences in lighter foals. Because optimal alignment with the aortic outflow tract improves the accuracy of Doppler-derived haemodynamic parameters, this technique offers veterinarians more reliable data for detecting early cardiac pathology in neonatal foals, particularly those presenting with clinical signs of compromise. Whilst further investigation in sick foals is warranted to establish clinical utility, practitioners can readily incorporate the subcostal view into routine neonatal cardiac screening protocols to strengthen diagnostic confidence.
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Practical Takeaways
- •The subcostal echocardiographic view is easily obtainable in recumbent newborn foals and should be incorporated into routine cardiac assessments for more accurate Doppler measurements of aortic flow
- •When comparing aortic velocity data between foals or referencing normal values, practitioners should specify which transducer site was used, as subcostal view yields higher velocities than standard parasternal approaches
- •This technique warrants investigation in sick neonatal foals and may improve cardiac assessment reliability in clinical cases where conventional parasternal views are suboptimal
Key Findings
- •The subcostal transducer view was feasible in all 23 newborn foals aged 7 hours to 6 days
- •Aortic diameter at sinus of Valsalva showed no significant difference between subcostal and parasternal views (P=0.06)
- •Aortic maximal velocity, velocity time integral, and pressure gradient were significantly greater from subcostal view than parasternal long-axis view (P<0.0001, P=0.0001, and P<0.0001 respectively)
- •Doppler velocity differences between views were especially pronounced in lower bodyweight foals, suggesting subcostal view provides better aortic outflow alignment