Cardiac pre‐purchase examination in horses – evaluation, outcome and athletic follow‐up

• Published in: Equine veterinary education 2022-10, Vol.34 (10), p.530-538
• Main Authors: Woort, F., Reef, V., Stefanovski, D., Slack, J.
• Format: Article
• Language: English
• Subjects: Abnormalities; Aorta; Arrhythmia; cardiac; Cardiac arrhythmia; Cardiomyopathy; Diagnosis; Fibrillation; Heart diseases; horse; Horses; Myocarditis; pre‐purchase; Prognosis; Regurgitation; sport horse; Tachycardia; Ventricle
• ISSN: 0957-7734; 2042-3292
• DOI: 10.1111/eve.13507

Summary This retrospective study describes the clinical, echocardiographic and electrocardiographic data for 174 horses presented for a cardiac evaluation as part of their pre‐purchase examination (PPE). Follow‐up information regarding outcome and performance was obtained via interview and/or FEI records. The objectives of this study were to (1) describe the abnormalities found on cardiac pre‐purchase examinations (PPE), (2) assess whether athletic prognosis generated by comprehensive cardiovascular examination at the time of the PPE was predictive of cardiac limitations to intended athletic activity and (3) evaluate whether signalment, murmur characteristics, presence of an arrhythmia or final diagnosis could predict either the prognosis or cardiac limitations to performance. The majority of horses had mild disease or physiological murmurs/arrhythmias (142 horses). However, performance‐limiting conditions were found in 29 horses, and this included moderate or severe mitral and aortic regurgitation, cardiomyopathy, myocarditis, large ventricular septal defects, an aortocardiac fistula, atrial fibrillation, atrial tachycardia with second degree AV block and frequent ventricular premature complexes during exercise. Athletic prognosis was excellent in 142 horses (with 60 normal horses and 82 horses with mild disease and an excellent prognosis), fair in 18 horses and poor in 11 horses. Athletic outcome was analysed in 96 horses. Prognosis given at the time of the PPE was the only significant predictor of the athletic outcome. Signalment, auscultation findings and diagnosis were not significantly associated with prognosis or outcome. Comprehensive cardiac examinations in horses with murmurs and arrhythmias at the time of the pre‐purchase examination should be recommended and provide a unique opportunity to eliminate at‐risk horses from the sport.