The equine cardiovascular system, particularly the heart, is fundamental to maintaining the health and performance of horses. The heart is responsible for pumping oxygenated blood throughout the body, supporting vital functions and physical activity. In horses, the heart's structure and function are adapted to meet the demands of both rest and exertion, with notable features such as a large cardiac output and efficient blood circulation. Conditions affecting the equine heart, such as arrhythmias, valvular diseases, and myocardial disorders, can significantly impact a horse's well-being and athletic capability. This page aggregates peer-reviewed research studies and scholarly articles that explore the anatomy, physiology, and pathophysiology of the equine heart, as well as diagnostic and therapeutic approaches to managing cardiac health in horses.
Glazier DB, Farrelly BT, O'Connor J.A congenital heart defect characterised by persistent patency (open-ness) of the ventricular septum, permitting flow of blood directly between ventricles, bypassing the pulmonary circulation and resulting in various degrees of cyanosis (blue discolouration of the skin) due to oxygen deficiency. Clinical signs include systolic murmur and a palpable thrill on both sides of the chest, dyspnoea and poor tolerance of exercise.
Scott EA, Kneller SK, Witherspoon DM.The physiologic closure of the ductus areteriosus was determined in 4 foals less than 16 hours old. The common carotid artery was catheterized, using local anesthesia and tranquilization, and contrast medium was injected into the ascending aorta. Radiographs were made of heart and great vessels during and after the injection to visualize the pathway of injected contrast medium.
Holmes JR, Rezakhani A.The paper describes changes observed in the T wave and T vectorcardiogram in horse after various periods of exercise. Using radiotelemetry and a bipole lead all horses showed negative T waves immediately after exercise. In some of them this was followed by a markedly positive T deflection. Possible reasons for these changes are briefly discussed.
Bisgard GE, Orr JA, Will JA.Hemodynamic measurements were made in 6 ponies at low altitude (Madison, WI, altitude, 250 m) and after 1, 2, 4, and 6 weeks at high altitude (Climax, CO, altitude, 3,400 m). The salient findings were that ponies maintain an increased heart rate and cardiac output and develop significant pulmonary hypertension at high altitude. The average control resting mean pulmonary artery pressure (BPpul) was 25.1 mm of Hg at 250 m; this value increased to 56.3 mm of Hg after 6 weeks at 3,400 m. An additional finding was that the pulmonary vascular response to acute hypoxia seemed to increase with time at...
Hillidge CJ, Lees P.Cardiac output in the horse was measured before and at predetermined times during 2-hour periods of thiopentone-halothane and thiopentone-diethyl ether anaesthesia. Left ventricular stroke volume was decreased to a similar extent during anaesthesia with each volatile agent, but a greater reduction in cardiac output occurred during halothane anaesthesia. This finding reflected the differing effects of halothane and ether on heart rate, a slight bradycardia occurring with the former agent while ether produced a small degree of tachycardia. The latter effect was attributed to enhanced sympathoadr...
Vitums A, Grant BD, Stone EC, Spencer GR.ABSTRACT Transposition of the aorta to the right ventricle with atresia of the pulmonary trunk was described in a 2 year old horse. Clinical and physiological examinations were performed and data recorded. Teratogenesis of the present anomaly was discussed and the literature reviewed. The probable course of circulation during the fetal life and after birth of this animal was suggested. An extensive col-lateral circulation was developed to the lungs, which might explain how the animal could live so long.
Smetzer DL, Senta T, Hensel JD.Each of nine horses was treated with amphetamine alone, with atropine alone, and with amphetamine and atropine in combination. Cardiac effects of these drugs were studied by electrocardiography during resting and exercising states and immediately after exercise. Although each treatment increased heart rate significantly during the resting state, only the amphetamine plus atropine treatment increased heart rate significantly during exercise. Decrease in heart rate immediately after exercise differed significantly for each treatment; the most rapid decrease in heart rate was found after the amph...
Else RW, Holmes JR.The normal histology of cardiac tissues has been described by many authors, for example Gross and Kugel (1931), Trautmann and Fiebiger (1952), Gould (1968), Bloom and Fawcett (1969) and Ham (1969). In the horse, a few reports have described microscopic valvular pathology in detail (Ackerknecht 1923, Imre 1933, Ubach and Cler 1944). Experimentally induced lesions have been reported by Wadsworth (1919), Wadsworth and Sickles (1927) and Miller (1944), and endocarditis was described by Winqvist (1945) and Dobin (1959, 1968).
In 1966, Smetzer, Bishop and Smith outlined the valvular pathology ass...
Holmes JR.This paper discusses certain aspects of circulatory physiology, including foetal circulation and the role of the thorax, and gives parameters for total blood volume, cardiac output, stroke volume and the distribution of blood between the pulmonary and peripheral circulation within the horse. The reader is taken on a journey around the circulatory system, beginning in the left atrium, into which richly oxygenated blood runs from the pulmonary veins. From here the blood is squeezed via the mitral valve into the left ventricular pump, where it is forced under high pressure through the peripheral ...
Elbrønd VS, Thomsen MB, Isaksen JL, Lunde ED, Vincenti S, Wang T, Tranum-Jensen J, Calloe K.The Purkinje fibers convey the electrical impulses at much higher speed than the working myocardial cells. Thus, the distribution of the Purkinje network is of paramount importance for the timing and coordination of ventricular activation. The Purkinje fibers are found in the subendocardium of all species of mammals, but some mammals also possess an intramural Purkinje fiber network that provides for relatively instantaneous, burst-like activation of the entire ventricular wall, and gives rise to an rS configuration in lead II of the ECG. To relate the topography of the horse heart and the dis...
Xue C, Cavanaugh SM.Reports of ante-mortem diagnosis of cardiovascular diseases in donkeys (Equus asinus) are rare. This case report describes the echocardiographic findings of suspected mitral valve dysplasia in a 3-year-old Nevisian donkey jenny presented for evaluation of a grade III/VI left-sided systolic murmur. Pertinent findings on transthoracic echocardiography included double mitral regurgitant jets and a bridge of tissue between the septal and mural mitral leaflets. Based upon the mild degree of cardiac remodeling and absence of clinical signs, therapeutic intervention was deemed unnecessary, and the je...
Bove AA.Myocardial blood flow is the major determinant of oxygen delivery to the myocardium, since oxygen extraction by the myocardium is near maximum in the resting state. Regulation of flow during exercise depends on local metabolic factors and, to a small extent, on autonomic tone. Maximum flow of 5-6 times resting has been measured in reactive hyperemia experiments. In strenuous exercise, myocardial oxygen delivery appears to be adequate and flow reserve seems capable of handling the increased oxygen demand. No evidence of myocardial failure in normal hearts due to excess exercise has been present...
Decloedt A, Van Steenkiste G, Vera L, Buhl R, van Loon G.Atrial fibrillation (AF) is the most common clinically relevant arrhythmia in horses, with a reported prevalence up to 2.5%. The pathophysiology has mainly been investigated in experimental animal models and human medicine, with limited studies in horses. Atrial fibrillation results from the interplay between electrical triggers and a susceptible substrate. Triggers consist of atrial premature depolarizations due to altered automaticity or triggered activity, or local (micro)reentry. The arrhythmia is promoted by atrial myocardial ion channel alterations, Ca2+ handling alterations, structural ...
Durando MM, Slack J, Birks E, Belcher C, Kohn C.Injuries and sudden death during the cross-country (XC) phase of eventing have raised interest in the frequency and types of cardiac arrhythmias occurring in these equine athletes. Objective: To characterise the frequency and types of rhythm disturbances and examine possible risk factors for premature depolarisations (PDs) occurring during the XC phase of United States Eventing Association (USEA) and Fédération Equestre Internationale (FEI)-sanctioned events. Methods: Prospective, cross-sectional study. Methods: Continuous electrocardiographic (ECG) recordings were obtained from horses prior...
Campolo A, Frantz MW, de Laat MA, Hartson SD, Furr MO, Lacombe VA.Endocrinopathic laminitis is pathologically similar to the multi-organ dysfunction and peripheral neuropathy found in human patients with metabolic syndrome. Similarly, endocrinopathic laminitis has been shown to partially result from vascular dysfunction. However, despite extensive research, the pathogenesis of this disease is not well elucidated and laminitis remains without an effective treatment. Here, we sought to identify novel proteins and pathways underlying the development of equine endocrinopathic laminitis. Healthy Standardbred horses ( = 4/group) were either given an electrolyte in...
De Lange L, Vera L, Decloedt A, Van Steenkiste G, Vernemmen I, van Loon G.Ventricular septal defects (VSDs) are the most common congenital cardiac defect in horses. Objective: To identify prevalence, age, breed, and sex distribution of VSD and to describe associated clinical and ultrasonographic findings. Methods: Hospital-based population of 21 136 horses presented to the equine internal medicine department. Methods: Medical records over a 12-year period were reviewed for VSD confirmed by ultrasonography. Age, breed, sex, sport discipline, murmur, clinical signs, outcome, VSD type, VSD size, shunt velocity, cardiac dimensions, concomitant cardiac anomalies, and v...
Burns JJ, MacMillan KM, John EE.Atrial fibrillation (AF) is the most clinically relevant cardiac arrhythmia identified in the Standardbred racehorse. However, there is limited literature regarding athletic ability in Standardbred racehorses following AF conversion. To investigate this issue, the objectives of this review were to: i) determine the success rate in using quinidine sulphate to treat AF in a population of hospitalized equine patients in Atlantic Canada between January 2008 and December 2019; and ii) measure return to athletic ability (using racetrack earnings and top-3 finishes) following cardioversion with quini...
Tzelos T, Blissitt KJ, Clutton RE.To determine whether preoperative electrocardiographic measurements linked to sympathetic nervous activity could be used to predict recovery quality after general anaesthesia in horses. Methods: Prospective, clinical study. Methods: Eighteen adult client-owned horses. Methods: The electrocardiogram (ECG) was recorded presurgery in horses under three standard conditions: stabled unattended; with a groom whilst being led along a standard course; alone in the induction box. After surgery, each animal's recovery quality was scored by eight experienced anaesthetists or technicians using Donaldson's...
Vernemmen I, De Clercq D, Decloedt A, Schauvliege S, Taeymans Y, De Wolf D, van Loon G.This report describes a rare case of an aorto-cardiac fistula in a six-year-old French Warmblood mare presented with atrial fibrillation, decreased performance, ventral oedema, bounding arterial pulsation and pathological jugular venous pulse. A 2.7-cm-diameter fistula connected the right aortic sinus of Valsalva to the right atrium. Atrial fibrillation was likely due to volume overload of the right heart due to left-to-right shunting. The horse was treated by percutaneous transcatheter closure of the fistula delivered under general anaesthesia using a transarterial approach. The operation was...
Leroux AA, Detilleux J, Sandersen CF, Borde L, Houben RM, Al Haidar A, Art T, Amory H.Risk factors for cardiac diseases in horses have not been explored in a large population of animals. Objective: To describe risk factors for various cardiac diseases in a hospital-based population of horses. Methods: Files of 3,434 horses admitted at the Internal Medicine Department of the Liege Equine Teaching Hospital between 1994 and 2011 were reviewed and of those, 284 were categorized as having moderate-to-severe cardiac disease. Methods: Observational study. After calculating prevalence for each cardiac disease, we tested whether breed (chi-square test) or sex, age, body weight (BW), and...
Young LE, Helwegen MM, Rogers K, Kearns L, Schreiber C, Wood JL.Exercise-induced pulmonary haemorrhage (EIPH) and tricuspid (TR) and mitral valve regurgitation (MR) are conditions with high prevalence in conditioned Thoroughbreds. Stress failure of pulmonary capillaries, leading to EIPH, is most likely when pulmonary vascular pressure is increased, and mitral regurgitation can result in pulmonary venous hypertension. Objective: There might be an association between MR and EIPH and the right ventricle (RV) of horses known to suffer repeated episodes of EIPH, as their hearts would be subject to higher pulmonary vascular pressures and cardiac output during tr...
Williams NJ, Furr M, Navas de Solis C, Campolo A, Davis M, Lacombe VA.Metabolic syndrome in humans is commonly associated with cardiovascular dysfunction, including atrial fibrillation and left ventricular diastolic dysfunction. Although many differences exist between human and equine metabolic syndrome, both of these conditions share some degree of insulin resistance. The aims of this pilot study were to investigate the relationship between insulin sensitivity and cardiac function. Seven horses (five mares, two geldings, aged 17.2 ± 4.2 years, weight 524 ± 73 kg) underwent insulin-modified frequently sampled intravenous glucose tolerance testing to determine ...
Khalesi H, Sakha M, Veshkini A, Rezakhani A.Heart murmurs and valvular regurgitation are common in horses and often have no effect on their performance. However, when structural changes occur in the heart size, they can affect performance adversely. This study aimed to examine the correlation between cardiac valves disease and poor performance in athletic horses. A total of 300 athletic Thoroughbred and mix-breed horses including 164 mares and 136 stallions, with a history of poor performance, were selected. Horses with cardiac murmurs were identified and further cardiac examination including precise auscultation, base-apex electrocardi...
Kraus M, Physick-Sheard PW, Brito LF, Schenkel FS.The number of Standardbred racehorses admitted to the Ontario Veterinary College Teaching Hospital (Guelph, Canada) for treatment of atrial fibrillation (AF) has been on the rise since the early 1990s. A small number of sires have been contributing to a large proportion of cases, indicating there may be a genetic predisposition to the arrhythmia in this breed. Objective: The objectives of this study were to determine the heritability of AF in Standardbred horses and whether heritability of the arrhythmia differs across gaits and/or sexes. Methods: Heritability study based on retrospective revi...
Bakos Z, Vörös K.Since percussion started to be a method forgotten and not trusted by many practitioners, the aim of the study was to demonstrate whether this procedure could deliver exact data if done accurately and by a practised examiner. The trial presented here included 31 healthy warm-blooded horses. Percussion of the area of cardiac dullness and then echocardiographic imaging of the same region were performed. To obtain the relevant measurement points, the 4th and 5th intercostal spaces (ICS) were used on the left and the 4th ICS on the right side. On the left side, the dorsal border of cardiac dullness...
Yamada S, Suruga K, Ogawa M, Hama T, Satoh T, Kawachi R, Nishio T, Oku T.The appearance of NO2- reducing activity of cytochrome c (Cyt c) upon heat denaturation was investigated with equine heart Cyt c. Denatured equine heart Cyt c (dCyt c), which was treated at 100 degrees C for 30 min, had NO2- reducing activity in the presence of dithionite and methylviologen in an aqueous solution under anaerobic conditions. In contrast, hemoglobin and myoglobin had no such activity under the same conditions. Using spectroscopic methods, we found that the appearance of this activity in the Cyt c was due to the following intramolecular changes: unfolding of the peptide chain, ex...
Finley MR, Li Y, Hua F, Lillich J, Mitchell KE, Ganta S, Gilmour RF, Freeman LC.In dogs and in humans, potassium channels formed by ether-a-go-go-related gene 1 protein ERG1 (KCNH2) and KCNQ1 alpha-subunits, in association with KCNE beta-subunits, play a role in normal repolarization and may contribute to abnormal repolarization associated with long QT syndrome (LQTS). The molecular basis of repolarization in horse heart is unknown, although horses exhibit common cardiac arrhythmias and may receive drugs that induce LQTS. In horse heart, we have used immunoblotting and immunostaining to demonstrate the expression of ERG1, KCNQ1, KCNE1, and KCNE3 proteins and RT-PCR to det...
Vitums A, Bayly WM.Three Arabian males foals were presented with cyanosis, heart murmur, and exercise intolerance, Results of clinical evaluation suggested a tentative diagnosis of ventricular septal defect in conjunction with malformations of the great arteries. Each foal had a poor prognosis and was killed at the owners' requests. At necropsy, the malformed hearts of the three foals were virtually identical. Each heart had a large defect in the upper interventricular septum. The aorta originated from the hypertrophied right ventricle and partially overrode the ventricular septal defect. The aortic ostium was g...
Reef VB, Mann PC, Orsini PG.M-mode, 2-dimensional, and contrast echocardiographic studies were used to detect tricuspid atresia in 2 foals. M-mode echocardiographic findings included a small right ventricle, large left ventricle, large mitral valve excursion, large left atrium (foal 2), dropout of the cranial aspect of the aortic root, and a thick band of echoes in the tricuspid valve region. These findings were confirmed by 2-dimensional echocardiography. In addition, a large right atrium, persistent foramen ovale, ventricular septal defect, and large mitral valve apparatus were imaged. One foal also had a thick right a...
Brumbaugh GW, Thomas WP, Hodge TG.A 4-year-old Quarter Horse gelding with atrial fibrillation, mitral regurgitation, and signs of bilateral congestive heart failure was initially treated IV with digoxin and furosemide. After parenteral digitalization, a daily maintenance dose of digoxin was administered orally at a rate of 21.7 micrograms/kg of body weight. At this dosage, a steady-state serum digoxin concentration of 2.3 ng/ml was achieved without clinical signs of toxicosis. The furosemide dosage was decreased and eventually discontinued as clinical improvement occurred. Clinical signs of congestive heart failure were contro...
Geimer TR, Ekström PM, Ludders JW, Erichsen DF, Gleed RD.The haemodynamic effects of hyoscine-N-butylbromide (0.30 mg/kg, intravenously) were studied in eight adult ponies in a blinded two-period crossover experiment with repeated measures. Values for heart rate were 63%, 48% and 13% greater than control values at 1, 16 and 46 min, respectively, after administration of hyoscine-N-butylbromide. Cardiac output increased by 16% at 16 min after drug injection. Mean right atrial pressure was decreased by 79%, 63%, 45% and 52% at 1, 16, 46 and 61 min, respectively, after drug administration. Stroke volume was decreased by 32% at 1 min and pulmonary arteri...
D' Fonseca NMM, Beukers M, Wijnberg ID, Navas de Solis C, de Ruijter-Villani M, van Doorn DA, Stout TAE, Roelfsema E.Changes in cardiovascular parameters, including blood pressure (BP) and cardiac anatomical dimensions, are an inconsistent feature of the equine metabolic syndrome. The order in which these changes arise is unknown. Objective: Determine the order in which EMS-associated changes in cardiovascular parameters arise. Methods: Twenty Shetland pony mares. Methods: High-energy (HE) diet mares were fed 200% of net energy requirements for 1 (n = 3) or 2 (n = 7) consecutive diet-years, with 17 weeks of hay-only between years. Noninvasive BP measurements and echocardiograms were performed during bo...
Tavanaeimanesh H, Dezfouli MR, Vajhi A, Rostam A, Akbarinejad V, Sadeghian Chaleshtori S, Corley KT.The cardiovascular effects and duration of action of hypertonic saline are not yet fully understood in the horse. Objective: To determine the effects of hypertonic saline on cardiac measurements derived from echocardiography over a period of 90 min after infusion in euvolaemic and healthy horses. Methods: Experimental study. Methods: Five healthy conscious euvolaemic horses were infused with 5 ml/kg bwt hypertonic saline via a jugular catheter over 1 h. Immediately prior to infusion and at 0, 20, 40, 60 and 90 min after the completion of the infusion, echocardiographic images were obtained fro...
Uhlendorf F, Gehlen H, Stadler P.The aim of the study was to extend the range of the electrocardiographic examination in horses, evaluating the practicability of special electrocardiographic techniques (exercise- and Holter-ECG) and comparing these with more common techniques (resting-ECG) in equine medicine. Methods: Electrocardiographic examination (resting-ECG for 1 minute, exercise-ECG and Holter-ECG) was performed in 20 horses without any clinical or echocardiographic findings and in 80 patients with abnormal findings (valvular regurgitation and/or atrial fibrillation). Results: In comparison with the resting-ECG, the ex...
Buschmann E, Van Steenkiste G, Boussy T, Vernemmen I, Schauvliege S, Decloedt A, van Loon G.We describe the diagnosis and treatment of an atrioventricular accessory pathway (AP) in a horse using 3-dimensional electro-anatomical mapping (3D EAM) and radiofrequency catheter ablation (RFCA). During routine evaluation of the horse, intermittent ventricular pre-excitation was identified on the ECG, characterized by a short PQ interval and abnormal QRS morphology. A right cranial location of the AP was suspected from the 12-lead ECG and vectorcardiography. After precise localization of the AP using 3D EAM, ablation was performed and AP conduction was eliminated. Immediately after recovery ...
Vernemmen I, Vera L, Van Steenkiste G, Deserranno B, Muylle S, Decloedt A, van Loon G.Arrhythmias are common in horses, but catheter-based minimally invasive electrophysiological studies and therapeutic interventions have been poorly explored in equine medicine, partly due to the lack of detailed anatomical knowledge of the equine heart. Objective: To describe the dimensions and anatomical features of some electrophysiologically important landmarks of the right atrium in detail and assess their correlation with bodyweight and aortic diameter. Methods: Ex vivo cadaveric study. Methods: Twenty-one hearts of Warmblood horses, subjected to euthanasia for noncardiovascular reasons, ...
Guthrie AJ, Killeen VM, Mülders MS, Grosskopf JF.The ratio of the cardiopulmonary blood volume to stroke volume is called the cardiopulmonary flow index (CPFI). The CPFI can be determined indirectly from the simultaneous recording of a radiocardiogram and an electrocardiogram. The CPFI and cardiac output were measured simultaneously in horses (n = 10) that were diagnosed as having cardiac disease. The diseased subjects were probably all exposed to feed contaminated with the ionophore, salinomycin, and all showed clinical signs indicative of chronic toxic myocarditis. The results obtained from these subjects were compared with those from cont...
Brown CC, Meyer RF, Grubman MJ.In a retrospective study, a negative-sense digoxigenin-labeled RNA probe, corresponding to the gene encoding nonstructural protein-1 of African horse sickness virus (AHSV) serotype 4, was applied to formalin-fixed, paraffin-embedded tissue taken from horses in the terminal stages of infection with AHSV. Fifteen infected ponies and one noninfected control were studied. Ponies exhibited a range of clinical signs and lesions. Thirteen ponies were infected with serotype 4, one with serotype 1, and one with serotype 2. Ponies were monitored clinically and euthanatized when severely clinically ill. ...
