Aortic rupture and aorto-pulmonary fistulation in the Friesian horse: characterisation of the clinical and gross post mortem findings in 24 cases.

Authors: Ploeg M, Saey V, de Bruijn C M, Gröne A, Chiers K, van Loon G, Ducatelle R, van Weeren P R, Back W, Delesalle C

Journal: Equine veterinary journal

DOI: 10.1111/j.2042-3306.2012.00580.x PubMed: 22607232Log in to save

Summary

# Aortic Rupture and Aorto-Pulmonary Fistulation in Friesians: Clinical Recognition and Post Mortem Characterisation Aortic rupture with aorto-pulmonary fistulation is a recognised but under-reported cause of sudden death in Friesian horses, prompting researchers at Utrecht University and Wolvega Equine Hospital to characterise the condition systematically across 24 cases collected over 13 years. Clinical presentation varied considerably: whilst some horses were found dead without warning, others displayed progressive signs including recurrent colic, peripheral oedema, sustained tachycardia, elevated rectal temperature and prominent jugular venous pulsation for weeks before cardiac collapse. Post mortem examination revealed that the majority of cases involved aortic rupture at the aortic arch proximal to the ligamentum arteriosum, typically accompanied by circumferential perivascular haemorrhage and concurrent aorto-pulmonary fistulation. The findings suggest this condition is considerably more prevalent in the Friesian breed than previously documented and that some cases represent progressive rather than purely acute pathology. For practitioners, the key clinical takeaway is that Friesians presenting with clusters of signs such as recurrent false colic, coughing, sustained tachycardia and peripheral oedema warrant aortic rupture in the differential diagnosis—and post mortem examination requires meticulous cardiac assessment to avoid missing this diagnosis.

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Practical Takeaways

•In Friesian horses presenting with recurrent false colic, coughing, tachycardia, or peripheral oedema, include aortic rupture and aorto-pulmonary fistulation in your differential diagnosis—these may be progressive conditions rather than acute emergencies
•Clinical signs may develop over weeks rather than presenting as sudden death; sustained tachycardia and bounding pulses with oedema warrant cardiac investigation in this breed
•Post mortem examination of Friesians requires meticulous dissection of the aortic arch near the ligamentum arteriosum to identify ruptures and fistulas; standard techniques may miss these lesions

Key Findings

•Aorto-pulmonary fistulation concurrent with aortic rupture near the ligamentum arteriosum is more common in Friesian horses than previously estimated
•Clinical signs including recurrent colic, peripheral oedema, and sustained tachycardia may persist for several weeks before acute cardiac failure, indicating progressive rather than purely acute pathology
•Some cases presented as sudden death without prior symptoms, while others showed progressive clinical deterioration with increased rectal temperature, bounding pulses, and jugular distension
•Post mortem findings typically include circumferential perivascular haemorrhage around the aortic rupture site, requiring careful examination technique to avoid missing the diagnosis

Conditions Studied

aortic ruptureaorto-pulmonary fistulationaortic sinus of valsalva aneurysmsaortic root tearsrecurrent colicperipheral oedematachycardiacardiac failure

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