Table 7.1 Summary: The clinical approach to horses with arrhythmias
Identify the arrhythmia by:
- Careful auscultation to identify the regularity of heart sounds and heart sound intensity. Identify the A sound if possible
- Simultaneous palpation of arterial pulse and auscultation of heart sounds
- Resting ECG
- Exercising ECG such as radiotelemetry
- Identifying how often the arrhythmia is occurring (persistent or intermittent)
- Establishing whether the arrhythmia is induced or abolished by changes in heart rate, vagal manoeuvres, excitement or exercise
Evaluate the clinical status of the patient:
- Can the signs be attributed to the arrhythmia?
- Is the animal. sufficiently compromised that it requires urgent treatment?
- Is there any evidence of underlying cardiac or systemic disease (clinical examination, echocardiography, clinical pathology, known side-effects of drugs)?
Treatment of the arrhythmia
- What, if any, treatment is required?
- What are the possible side-effects of the drug, what is its cost?
- How does the pharmacology of the drug dictate its use?