Pathology in Practice

Ascending aortic aneurysm associated with tetralogy of Fallot in an adult mare

Congenital heart disease is relatively uncommon in horses. Only three reports exist that describe a tetralogy of Fallot in adult horses. Whereas in humans the presence of congenital heart disease constitutes a risk factor for developing aortic aneurysms, their association has never been reported in horses. Here, we present a case with a large ascending aortic aneurysm as a complication of a tetralogy of Fallot in an adult mare. The mare was referred with sustained tachycardia and a 5 days history of mild intermittent colic, depression, inappetence and weight loss. Echocardiography was used to characterize the cardiac abnormalities and aortic root dilation. Due to the poor prognosis, the mare was euthanized and post‐mortem examination further characterized the abnormalities. At least four factors contributed in this case to the development of aortic haematoma: congenital disease, mucoid extracellular matrix accumulation vasa vasorum dysfunction and inflammatory/degenerative lesions in the aorta's intima. Although colic is primarily caused by gastrointestinal issues, cardiac disease should be suspected in cases with sustained tachycardia, even in absence of murmurs or arrhythmias. Despite the fact that congenital abnormalities are usually detected in foals, they may sometimes remain unnoticed for several years.