Iatrogenic pneumothorax‐induced heart murmur during standing laparoscopy in a 3‐year‐old horse
Authors: Fernández‐Parra Rocio, Losada‐Floriano Andres, Zilberstein Luca, Bourzac Celine
Journal: Equine Veterinary Education
Summary
# Editorial Summary A 3-year-old Selle Français stallion undergoing standing laparoscopic inguinal ring closure developed an iatrogenic pneumothorax when air entered the thoracic cavity during the minimally invasive procedure. Coinciding with the pneumothorax, a previously absent cardiac murmur became audible on auscultation, though thoracic air precluded definitive echocardiographic assessment at that time. Over the subsequent 48 hours, as the pneumothorax resolved spontaneously, the murmur disappeared entirely and follow-up echocardiography revealed no structural or functional cardiac pathology. This case demonstrates that transient murmurs detected during standing laparoscopy may represent acoustic artefacts or haemodynamic changes secondary to thoracic air rather than primary cardiac disease, and that clinical resolution of the pneumothorax can be diagnostic in itself. For practitioners performing standing surgical procedures, awareness of pneumothorax as a potential complication and recognition that associated cardiac auscultatory findings may be iatrogenic and reversible is important for clinical decision-making and preventing unnecessary intervention during the acute post-operative period.
Read the full abstract on the publisher's site
Practical Takeaways
- •Be aware that pneumothorax is a potential iatrogenic complication of standing laparoscopic procedures and can cause transient cardiac auscultation findings that resolve with pneumothorax resolution
- •New heart murmurs detected during or immediately after standing laparoscopic procedures may be secondary to pneumothorax rather than indicating primary cardiac disease
- •Careful monitoring and conservative management of iatrogenic pneumothorax can result in complete resolution without permanent complications
Key Findings
- •Iatrogenic pneumothorax developed during standing laparoscopic inguinal ring closure in a 3-year-old horse
- •A transient heart murmur appeared immediately following pneumothorax induction, not present on preoperative examination
- •Heart murmur resolved completely within 2 days following resolution of the pneumothorax with no structural cardiac abnormalities detected