Transthoracic echocardiography and its limitations in the diagnosis of congenital supernumerary aortic valve in a Thoroughbred.
Valentina VitaleMalene LaurbergGaby van GalenPublished in: Veterinary medicine and science (2021)
Aortic valve malformation is a common congenital abnormality reported in human medicine. The malformation is characterised by an increased or decreased number of cusps. Anatomical variations of the aortic valve that have been documented in humans include unicuspid, bicuspid, quadricuspid and quinticuspid valves. Two reports described a quadricuspid aortic valve in horses associated with either a ventricular septal defect (VSD) or tetralogy of Fallot. In this case report we describe the clinical and echocardiographic findings of a horse with a quadricuspid aortic valve as single congenital abnormality, referred with history of exercise intolerance and an episode of paroxysmal atrial fibrillation. Limitations and risks of misdiagnosis that can be encountered with transthoracic echocardiography are also discussed. The reported case highlights the importance of echocardiographic screening in asymptomatic patients as congenital heart disease can be present without obvious cardiac signs. As advanced imaging on the equine thorax is still far from future possibilities for adult horses, this report may help to reach an accurate diagnosis with similar cases.
Keyphrases
- aortic valve
- left ventricular
- aortic stenosis
- transcatheter aortic valve replacement
- aortic valve replacement
- transcatheter aortic valve implantation
- atrial fibrillation
- congenital heart disease
- ejection fraction
- pulmonary hypertension
- left atrial
- case report
- heart failure
- high resolution
- catheter ablation
- end stage renal disease
- computed tomography
- endothelial cells
- chronic kidney disease
- physical activity
- newly diagnosed
- prognostic factors
- coronary artery disease
- oral anticoagulants
- climate change
- young adults
- emergency department
- resistance training
- body composition
- acute coronary syndrome
- drug induced