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View Full Version : Correct Vet term for what is being called equine "heart attack"?



SevenDogs
Mar. 27, 2011, 03:42 PM
Deltawave and others: I understand from your posts that horses do not have "heart attacks" the way humans do. Can you provide a term that we can use for the catastrophic events that occasionally occur with horse out on XC, as well as at home in turn-out/lunge line, arena work, etc? It needs to be fairly general, so that it can be used prior to having the exact cause of death, but more accurate than "heart attack".

I think we all want to distinguish this type of issue from those associated with jumps and/or trauma, but don't know what to call it... hence "heart attack". I noticed even EN is reporting a suspected "heart attack" and they are usually the most accurate, so I think they would appreciate a more accurate term as well.

Thanks!

kerilli
Mar. 27, 2011, 03:58 PM
I found this on yahoo answers, it's a start i hope:

"It isn't that they can't die of heart attack, but it is extremely rare. A heart attack is also called a myocardial infarction. It means that a coronary artery becomes blocked and the area of heart muscle supplied with blood by the blocked artery undergoes tissue death. Myocardial refers to the heart muscle, and infarction refers to the tissue death following cessation of blood supply. Death is not inevitable when a heart attack occurs. It depends on the location and size of the area of muscle tissue death, and the effect on the electrical system of the heart.

Because horse's don't eat animal fats, they rarely develop atherosclerotic heart disease the way humans do. It is the arterial plaques that typically block coronary arteries in heart attacks.

Most sudden equine deaths that are being called "heart attacks" by everyone on here are actually from either a ruptured aorta or cardiac arrest. Cardiac arrest means the heart stops beating. It is an electrical malfunction, and not a myocardial infarction.

From what I've read, Seabicuit was never necropsied to verify a cause of death, so it is impossible to say whether or not he actually died of a heart attack. Anyway, it can happen, but very rarely does."

SevenDogs
Mar. 27, 2011, 04:43 PM
Thanks Kerilli! Appreciate the info and it is very interesting.

I think what I am looking for is a general term that we can use to replaced "suspected heart attack", but is still immediately understandable by the general public. Everyone understands heart attack, but if that isn't accurate, is there something better?

kerilli
Mar. 27, 2011, 05:06 PM
well, going from that article, 'suspected cardiac arrest'... but i thought that was what was meant by a 'heart attack' anyway...

SevenDogs
Mar. 27, 2011, 05:30 PM
well, going from that article, 'suspected cardiac arrest'... but i thought that was what was meant by a 'heart attack' anyway...

I think a lot of us (me included) think heart attack and cardiac arrest are the same thing! :)

MeghanDACVA
Mar. 27, 2011, 07:24 PM
I think a lot of us (me included) think heart attack and cardiac arrest are the same thing! :)

No, you can go into cardiac arrest from having a heart attack but they are not the same.
And saying somebody/thing died of cardiac arrest is usually pretty stupid. We ALL die because our heart stopped beating. Duh. ;-)

Horses that die on course have typically ruptured some large vessel. It may the aorta in either the chest or the abdomen. It may one of atria. It may be a large pulmonary vessel.

We were at Rolex some years ago when this happened at the Lexington Bank. Horse did the first element fine. Struggled at the second (on the top of the bank) and was dead when it fell over the 3rd (going down hill so momentum helped carry it along).

SevenDogs
Mar. 27, 2011, 08:11 PM
So Meghan, what would be a good general term to use for these situations as opposed to "suspected heart attack", prior to having the actual cause of death?

It seems to bother the folks with medical knowledge that "suspected heart attack" is used. What would be more appropriate?

Grataan
Mar. 27, 2011, 08:19 PM
Ruptured aorta, pulmonary embolism, ruptured atria, ruptured aneurysm, etc

SevenDogs
Mar. 27, 2011, 08:29 PM
Here's what I'm after: A phrase that summarizes all of the issues Grataan lists (and any others). Are all of those things pulmonary issues so you could say that a horse died of suspected pulmonary failure or complications vs suspected "heart attack"?

I started this thread out of respect for those medical professionals who object to heart attack.

KaBoom!
Mar. 27, 2011, 08:31 PM
Cardiovascular collapse comes to mind.

I agree see in print that a horse died of a heart attact just does not make sense.

Laurierace
Mar. 27, 2011, 08:35 PM
You won't have a specific term until the results from that particular horse's necropsy. Maybe the umbrella term cardiac event?

Grataan
Mar. 27, 2011, 09:15 PM
Here's what I'm after: A phrase that summarizes all of the issues Grataan lists (and any others). Are all of those things pulmonary issues so you could say that a horse died of suspected pulmonary failure or complications vs suspected "heart attack"?

I started this thread out of respect for those medical professionals who object to heart attack.

There isn't one correct term, that's why we call them the separate terms.

If anything, news reports and press releases should say "Collapsed" or "COD: unknown/unlisted pending necropsy results"

RAyers
Mar. 27, 2011, 09:21 PM
....

Horses that die on course have typically ruptured some large vessel. It may the aorta in either the chest or the abdomen. It may one of atria. It may be a large pulmonary vessel.

....

Except that in several necropsies, no blood was found pooled in the tissues. There was no indication of rupture etc. In necropsies on hunt horses, they found that the heart suffered massive accumulative damage due to the "slamming" of organs against the chest most likely from going off banks etc.

I am familiar with a few that showed no signs of "rupture" in the sense of obvious bleed out all the way back to Hazmat.

Reed

deltawave
Mar. 27, 2011, 10:42 PM
The term that is probably best here is "sudden cardiac death", but even that term implies a fatal arrhythmia if you were to poll a bunch of experts. And since we REALLY HAVE NO IDEA why many of these horses are dying, it is really hard to be precise.

Sudden death is a better term than "heart attack", but there probably isn't one unifying diagnostic term, since these horses have demonstrated a variety of fatal things including rupture or dissection of the great vessels, (NOT the same as an aneurysm, but can include aneurysms), massive pulmonary hemorrhage, cardiac tamponade (fluid in the pericardium), bleeding from a large vessel in the abdomen, fatal arrhythmia, etc.

Still more questions than answers, sadly. :(

"Cardiac arrest" implies either the heart just stopping (incredibly rare) or a malignant/fatal arrhythmia like ventricular tachycardia or ventricular fibrillation. That is possibly ONE of the causes of horse deaths, but would not really be an accurate term for a horse that has had an aortic dissection or a fatal lung bleed. An arrhythmic death is often presumed if there is nothing on autopsy to otherwise explain the death.

subk
Mar. 28, 2011, 10:21 AM
Since we don't actually know what the cause of death is (yet) I actually LIKE the term "heart attack" precisely because it is an unspecific, non medical term. Hearts don't really attack in the first place and the term already covers multiple medical possibilities so expanding it to cover any traumatic suspected cardio/circulatory event works pretty well.

deltawave
Mar. 28, 2011, 11:20 AM
Except heart attack is NOT a broad, nonspecific term at all. That's the problem. A heart attack is a myocardial infarction, and nothing else. And horses don't get myocardial infarctions.

DarkStarrx
Mar. 28, 2011, 11:29 AM
Horse & Hound just stated this morning Spring Ahead died of a heart attack??

http://www.horseandhound.co.uk/news/397/306550.html

Why does everyone use the term then??

deltawave
Mar. 28, 2011, 01:08 PM
Ignorance and lack of awareness, mainly. Just like people say "Xerox" when they mean "photocopy" or "Coke" when they mean "cola". Except in the case of heart attack they're using a term in a broad, nonspecific way when in fact it is a fairly precise term in medical-jargon-land.

It's not THAT big a deal, but it is not SO hard to be precise, and when one is in the business one tries to not use medical terms in a sloppy way. Reporters, IMO, should make the effort to be precise, too.

SevenDogs
Mar. 28, 2011, 01:22 PM
Deltawave: I have to be honest. I started this thread in the hopes that there was a general, easily understood term out there to replace "suspected heart attack" when the true cause is not yet determined. But, so far, there doesn't seem to be one.

Personally, I think it is important to be able to report on a likely cause of death, BEFORE necropsy or determination of actual cause of death. In the "information age" a horse death IS going to be reported immediately and I think it is relevant to distinguish between a jump related, trauma type situation and what we are talking about here.

In absence of anything better, I'm probably going to stick with "suspected heart attack". Even though it is technically wrong, it accomplishes the goal and I'm not hearing anything better to replace it.

Where'sMyWhite
Mar. 28, 2011, 01:26 PM
And saying somebody/thing died of cardiac arrest is usually pretty stupid. We ALL die because our heart stopped beating. Duh. ;-)

But sometimes you die because your heart stopped and sometimes your heart stops because something else happened first...


We were at Rolex some years ago when this happened at the Lexington Bank. Horse did the first element fine. Struggled at the second (on the top of the bank) and was dead when it fell over the 3rd (going down hill so momentum helped carry it along).

I was there for that same event... about 50 feet from the bank and saw the whole thing. Definitely tragic and hard to forget.

deltawave
Mar. 28, 2011, 01:31 PM
Again, nothing wrong with "sudden death", if one is looking for a broad, accurate term. :) This could be contrasted with "catastrophic breakdown" in the case of fracture, etc.

I totally realize it's not important to a huge majority of people. But if I were watching an auto race and a car started belching fire and smoke out of its tailpipe, I'd be better off saying "woah, engine trouble" than "oh, he cracked a blahblahwhoozit". :D And if I were a reporter, I'd try to come up with a term that was descriptive but not WRONG, which is the case when one uses "heart attack" in anything relating to horses.

Semantics, I get it. Just a personal crusade I have, to use medical terminology with precision. :)

ride3day
Mar. 28, 2011, 03:48 PM
I work in human cardiology. Seeing "heart attack" as a description in equine articles makes me cringe due to the incorrect terminology as described by other posters. I like Laurirace's term of "cardiac event". Or to be more encompassing "cardiovascular event" could cover electrical, heart and vessel possibilities.

Where'sMyWhite
Mar. 28, 2011, 05:01 PM
But if I were watching an auto race and a car started belching fire and smoke out of its tailpipe, I'd be better off saying "woah, engine trouble" than "oh, he cracked a blahblahwhoozit". :D And if I were a reporter, I'd try to come up with a term that was descriptive but not WRONG, which is the case when one uses "heart attack" in anything relating to horses.

DW, a side comment but has always made me giggle (and would do the trick for the car description) is an oil pan failure... failure of the oil pan to contain all the engine parts :eek:

deltawave
Mar. 28, 2011, 06:25 PM
Sort of like hockey players having "upper body injuries". Vague much? :lol:

skip916
Mar. 28, 2011, 11:10 PM
delta- what exactly could/would cause pericardial tamponade in the horse? just wanted to compare with humans for curiosity's sake. infection, hypothyrodism- or just blunt trauma?

deltawave
Mar. 28, 2011, 11:28 PM
From what I understand, aortic dissection down to the aortic root and then into the pericardium is a leading cause in horses, as it is in humans when tamponade is sudden. That doesn't mean it's common, but it's on the list of suspects. It's reasonably well described in breeding stallions who suffer sudden death "on the job".

MeghanDACVA
Mar. 29, 2011, 03:54 PM
Personally I don't care what anybody calls it, AS LONG AS "YOU" know they are using the incorrect term in this case.
Personally I like "sudden death" or "acute collapse". Until necropsy results are in. Though those seldom make the news later.
As for a "bleed out" that doesn't result in a body cavity full of blood...
Ditto Deltawave and cardiac tamponade. It doesn't take much blood to acutely accumulate in the pericardial sac to cause acute death. I see that all too frequently in my job.
Pulm hemorrhage doesn't have to be "massive" either to cause death.

My hubby works the race track as the TRACK vet, ie the one on the track during races. Acute collapse and death occurs there too. But again, necropsy results are seldom/never made public.

If a horse truly dies of a "Heart Attack", ie a myocardial infarction I would like to see the necropsy and histopath results. And I am sure the reports verifying this would show up in the veterinary literature. And so far I have not seen anything regarding myocardial infarctions in non-humans. Except for turkeys. If there IS data out there and somebody has it, I would be seriously interested in seeing it. Seriously, not being snarky.

Ohhh, along this line does everybody know the difference between a necropsy and an autopsy? Just more trivia but is also an issue of use of correct terms. ;-)

deltawave
Mar. 29, 2011, 04:16 PM
Horses can get MIs from strongyle infestation, can't they? This is also implicated in aortic pathology as well, IIRC. Which is still not to say that they get coronary blockages or garden-variety heart attacks like people or bunnies. I thought it was aortic dissections that caused turkeys to croak?

scubed
Mar. 29, 2011, 06:02 PM
Necropsy is the same thing as an autopsy. The prefix "auto" means self, therefore, when performed on "one of our own" (i.e. human) it is called an autopsy. But a human does one on a non-human (horse, dog, whatever), the term necropsy is used.

scubed
Mar. 29, 2011, 06:05 PM
This is interesting reading: http://books.google.com/books?id=-3anmObYe-AC&pg=PA7&lpg=PA7&dq=myocardial+infarction+equine&source=bl&ots=4UngBsjKqX&sig=9xNhe_TZNLNuBIPki7pnBIgz99c&hl=en&ei=R1eSTaCqG8PG0QGZqZTNBw&sa=X&oi=book_result&ct=result&resnum=8&ved=0CFUQ6AEwBw#v=onepage&q=myocardial%20infarction%20equine&f=false

MeghanDACVA
Mar. 29, 2011, 09:25 PM
Necropsy is the same thing as an autopsy. The prefix "auto" means self, therefore, when performed on "one of our own" (i.e. human) it is called an autopsy. But a human does one on a non-human (horse, dog, whatever), the term necropsy is used.

:-) Good goin'!
It always tickles me when someone talks a dog (etc) having an autopsy done. I have this immediate mental image of a dog (or etc) standing over another dog (or etc) with a knife, etc in its paw. :-)

I am not aware of stronglyes causing MI's. Arotic dissecting aneursyms, yes. Do you have a reference source?
Turkeys are (or were) the animal model for coronary artery disease.

deltawave
Mar. 29, 2011, 09:47 PM
I am not aware of stronglyes causing MI's. Do you have a reference source?

Read scubed's link. Also a number of citations on PubMed.

And if you really want to pick nits, "dissecting aneurysm" is two different diagnoses, not necessarily seen together. :) There are dissections without aneurysms and aneurysms without dissections. Only every now and then is there "both". Even my non-cardiology, non-thoracic, non-surgical colleagues are guilty of that one. But I'm probably guilty of using archaic or slightly unclear terms that make Urologists or Orthopedists cringe too, I guess! :lol:

Every model I've ever seen in animal studies of CAD was with bunnies eating bad diets. :lol: I was always taught that turkeys just rupture their aortas.

deltawave
Mar. 29, 2011, 09:50 PM
http://www.worldpoultry.net/diseases/aortic-rupture-d6.html