Two-dimensional echocardiographically guided pericardiocentesis in a horse with traumatic pericarditis.

The study discusses a case of a horse with suspected pericarditis, which was diagnosed through two-dimensional echocardiographic (2DE) examination and treated with echocardiographically guided pericardiocentesis. Despite the treatment, the horse’s condition gradually worsened leading to its euthanization. Postmortem analysis revealed the presence of chronic pericarditis caused by a traumatic stab wound.

Introduction

• In the paper, the researchers present a case study about a horse showing symptoms of pericardial effusion, a condition where excess fluid builds up in the sac around the heart (the pericardium).

Diagnosis

• The team performed a two-dimensional echocardiographic (2DE) examination to investigate the cause of the symptoms. They observed hallmark signs of cardiac tamponade, a life-threatening condition where pressure in the pericardium prevents the heart from functioning properly.
• The authors also suspected fibrinous pericarditis, which is inflammation of the pericardium with deposits of fibrin, by spotting fibrinous strands in the pericardial fluid and epicardial fibrin deposits.

Treatment

• Guided by echocardiography, the team performed pericardiocentesis, a procedure to remove excess fluid from the pericardium. From this process, 4 liters of fluid were extracted and the bacterium Streptococcus zooepidemicus was identified.
• The procedure was repeated for three consecutive days along with medication administration. However, the horse showed only temporary improvement in cardiac function before its health began to decline.

Euthanasia and Necropsy

• Due to the deterioration in the condition of the horse, euthanasia was performed on the ninth day of hospitalization.
• A postmortem examination revealed that the horse had chronic serofibrinous pericarditis of traumatic origin, meaning chronic inflammation of the pericardium with fibrin deposits caused by a trauma or injury.
• The cause of the pericarditis was found to be an intercostal stab wound, which had penetrated the pericardium and the myocardium (the muscle layer of the heart) – this finding linked the origin of the problem back to a traumatic event.