Equis ISSN 2398-2977

Heart: pericarditis

Introduction

• Pericarditis in association with a pericardial effusion is a rare clinical entity in the horse.
• Cause: penetrating wounds, extension of infection from adjacent structures, septicemia, neoplasia.
• Signs: tachycardia, ventral edema, jugular venous distension, diminished heart sounds.
• Diagnosis: clinical signs, echocardiography, pericardiocentesis, radiography.
• Treatment: treatment of underlying cause, pericardiocentesis
• Prognosis: guarded but better if condition diagnosed and treated early.

Pathogenesis

Etiology

• Most commonly, pericardial effusion results from an idiopathic aseptic pericarditis. Effusive and fibrinous types recognized.
• Neoplasia.
• Secondary to penetrating thoracic wounds.
• Extension of infection from adjacent structures.
• Septicemia.

Pathophysiology

• Pericardial effusion   →   restriction of ventricular dilation and impedes atrial and ventricular filling.
• This decreases end-diastolic volumes   →   poor cardiac output   →   sympathetic nervous system and renin-angiotensin-aldosterone system activated   →   tachycardia, vasoconstriction, retention of sodium and water   →   increased end-diastolic atrial pressure   →   increased ventricular filling pressures   →   backward cardiac failure   →   increased central venous pressure   →   jugular distension, abdominal and pleural effusions, ventral edema.
• Right side of heart more susceptible because of thin wall.

Diagnosis

Treatment

Outcomes