Diagnosing and Managing Horses with Cardiac Failure in the Emergency Clinic

Presentation Description / Summary: In horses, overt clinical signs of cardiac disease at rest often only occur when severe cardiac dysfunction is present. Clinical identification of cardiac failure in horses may not be straightforward. Horses may present with the characteristic signs of left-sided heart failure such as dyspnea and tachypnea indicating pulmonary edema or signs of right-sided heart failure such as ventral edema and distended jugular veins. Cardiac auscultation in such cases usually reveal tachycardia, a murmur or an arrhythmia. However, depending on the underlying structural or functional cardiac disorder and the stage of cardiac failure, horses may only display unspecific clinical signs such as lethargy and unexplained tachycardia which is often interpreted as colic. Time-sensitive identification of patients with cardiac failure is important to initiate emergency treatment and ensure optimal management of such cases. Cardiac point-of care ultrasound (POCUS) is a valuable tool to aid in the clinical evaluation of patients. Specific POCUS protocols such as equine Focused Cardiac Ultrasound (eFoCUS) or Cardio Respiratory Assessment with Sonography in the Horse (CRASH) are designed for rapid real-time assessment of cardiac patients. Portable hand-carried ultrasound (HCU) devices facilitate the use of cardiac POCUS in virtually any location. Mobile ECG devices are available for diagnosing life-threatening cardiac arrhythmias that require immediate anti-arrhythmic treatment. Immediate therapeutic intervention is of utmost importance in patients with cardiac failure and is aimed at reducing hemodynamic consequences, increasing cardiac output and decreasing congestion.

Learner Outcomes: Know the clinical presentation of horses with cardiac failure Become familiar with point-of-care assessment tools Gain knowledge about emergency treatment