Idiopathic, aseptic, effusive, fibrinous, nonconstrictive pericarditis with tamponade in a standardbred filly.
Abstract: A Standardbred filly was admitted for evaluation of pleuritis and pneumonia. Heart rate was 80 to 120 beats/min, and the pulse was barely palpable. Thoracic and abdominal ultrasonography and echocardiography revealed substantial pericardial effusion with cardiac tamponade, fibrinous pericarditis, pleural effusion, and ascites. Initial electrocardiography revealed normal sinus rhythm with decreased amplitude of the QRS complexes consistent with pericardial effusion. Following thoracentesis, echocardiogram-guided pericardiocentesis was performed. Bacterial culture yielded no growth from any of the fluids, and bacteria were not seen on cytologic examination. Initial treatment included broad-spectrum antibiotic treatments, IV fluid therapy, and anti-inflammatory agent administration. On the basis of negative culture results, an immune-mediated cause was considered, and dexamethasone was instituted in a decreasing dosage regimen. Pericardial effusion, ventral edema, and ascites began to resolve within 3 days after beginning dexamethasone treatment. Thirty days following discharge, the filly was reexamined, and at that time, the prognosis for athletic performance was considered good so the horse was returned to race training. The final diagnosis in this case was idiopathic, effusive, nonconstrictive pericarditis with tamponade. Early identification, clinical understanding, and application of knowledge of the pathophysiologic mechanisms of pericarditis in horses, combined with use of diagnostic aids such as ultrasonography and aggressive therapy consisting of effusion drainage, pericardial lavage, antibiotics that penetrate the pericardium, and corticosteroids when indicated are critical for a successful outcome in horses with pericarditis.
Publication Date: 1992-11-15 PubMed ID: 1289343
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Summary
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This research documents the case of a young standardbred horse that was diagnosed with idiopathic effusive nonconstrictive pericarditis with cardiac tamponade, a condition characterised by excess fluid accumulation around the heart. The horse was examined and treated using various methods, including surgery, antibiotics, fluid therapy, and corticosteroids, leading to recovery and rehabilitation.
Case Overview
- The research revolves around a standardbred filly who was admitted for investigation of pleuritis and pneumonia. She was found to have a heart rate of 80 to 120 beats per minute and a hardly discernible pulse.
- With the usage of thoracic and abdominal ultrasonography and echocardiography, significant pericardial effusion (accumulation of excess fluid around the heart) was discovered with associated cardiac tamponade (pressure on the heart due to fluid in the sac). Fibrinous Pericarditis (inflammation of the pericardium tissue), pleural effusion (excess fluid in the lungs), and ascites (excess fluid in the abdomen) were also observed.
Diagnostic Tests
- An initial electrocardiography was performed, which showed normal rhythm with diminished amplitude of the QRS complexes, a sign consistent with pericardial effusion.
- A procedure called thoracentesis involving removal of fluid from the pleural space, and echocardiogram-guided pericardiocentesis, a process to remove fluid from the pericardium, were carried out.
- The extracted fluids underwent bacterial culture tests, which showed no bacterial growth. Cytologic examination also did not show any bacteria, implying an aseptic (non-infectious) condition.
Treatment Administered
- Initial treatment involved broad-spectrum antibiotics, intravenous fluid therapy, and administration of anti-inflammatory drugs.
- Given the negative outcome of the bacterial culture, the researchers considered an immune-mediated cause, and commenced treatment with dexamethasone (a corticosteroid) in a decreasing dosage regimen.
- Pericardial effusion, ventral edema, and ascites began to reduce within three days after the initiation of dexamethasone treatment.
Outcome and Conclusion
- Thirty days after being discharged, the horse was reexamined and showed good prognosis for athletic performance and was hence returned to racing training.
- The final diagnosis for the case was idiopathic (unknown cause), effusive nonconstrictive pericarditis with tamponade, which was effectively managed with the use of diagnostic aids, timely identification, appropriate clinical understanding of the pathophysiologic mechanisms, and aggressive therapeutic strategy.
Cite This Article
APA
Robinson JA, Marr CM, Reef VB, Sweeney RW.
(1992).
Idiopathic, aseptic, effusive, fibrinous, nonconstrictive pericarditis with tamponade in a standardbred filly.
J Am Vet Med Assoc, 201(10), 1593-1598.
Publication
Researcher Affiliations
- Department of Clinical Studies, School of Veterinary Medicine, University of Pennsylvania, Kennett Square 19348.
MeSH Terms
- Animals
- Ascites / complications
- Ascites / veterinary
- Cardiac Tamponade / complications
- Cardiac Tamponade / diagnosis
- Cardiac Tamponade / therapy
- Cardiac Tamponade / veterinary
- Diagnosis, Differential
- Electrocardiography / veterinary
- Female
- Horse Diseases / diagnosis
- Horse Diseases / therapy
- Horses
- Pericardial Effusion / complications
- Pericardial Effusion / veterinary
- Pericarditis / complications
- Pericarditis / diagnosis
- Pericarditis / therapy
- Pericarditis / veterinary
- Pleural Effusion / complications
- Pleural Effusion / veterinary
Citations
This article has been cited 3 times.- Chapuis RJJ, Ragno VM, Ariza CA, Movasseghi AR, Sayi S, Uehlinger FD, Montgomery JB. Septic fibrinous pericarditis in 4 horses in Saskatchewan following an outbreak of forest tent caterpillars in 2017. Can Vet J 2020 Jul;61(7):724-730.
- Yamada K, Sato F, Horiuchi N, Higuchi T, Kobayashi Y, Sasaki N, Nambo Y. Autopsy imaging for cardiac tamponade in a Thoroughbred foal. J Equine Sci 2016;27(3):115-118.
- Maeda Y, Kanno C, Sugiyama M, Yamamoto R, Sato S, Ando R, Noda R, Kawaguchi H, Takahashi F. Sudden death in a Thoroughbred stallion: cardiac tamponade due to transverse aortic rupture with bone metaplasia and calcification. J Equine Sci 2025 Jun;36(2):75-79.
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