Myocardial contusion and rib fracture repair in an adult horse.

This research article presents the case of an adult horse that suffered myocardial injury due to a severe blunt force trauma to the chest leading to a rib fracture. The study details the diagnostic procedures, the surgical methods employed to repair the rib fracture, and the treatment used to manage the myocardial damage, indicating successful recovery.

Key Clinical Findings and Management of Myocardial Injury

• The 6-year-old horse had experienced blunt chest trauma that led to a comminuted fracture of its left 5th rib. The fractured fragment was situated over the left atrium and coronary artery, which triggered hemothorax and dyskinesis of the left ventricle.
• The trauma was also responsible for causing myocardial injury, as evidenced through atrial fibrillation, the occurrence of ventricular ectopy, and a heightened concentration of cardiac troponin I in the plasma.

Surgery and Treatment Procedure

• Under general anesthesia, the rib fracture was repaired employing a wire and plate technique.
• During the surgery, local infusion of mepivicaine was administered for intercostal perineural analgesia. This coincided with the conversion of atrial fibrillation to normal sinus rhythm.
• Through continuous, resting and exercising electrocardiograms, serial cardiac troponin I concentrations and echocardiograms, the progress of myocardial injury was closely monitored.
• The horse was hospitalized for 5 days post-surgery and then discharged.

Reexaminations and Outcome

• The horse was reexamined 3 and 15 months after the incident, with the results indicating the fracture had healed effectively and no sign of myocardial sequelae was found.

Conclusion and Insights for Future Cases

• The information provided in this research helps to enhance veterinary knowledge, as this is the first documentation of diagnosis, surgical repair and management of myocardial injury due to blunt chest trauma in an adult horse. It highlights the capability to successfully manage rib fractures and myocardial traumas in horses, and underscores the need to consider myocardial injury in cases of thoracic trauma.