Complete atrioventricular septal defect (AVSD) is rarely reported in horses. We retrospectively reviewed three Thoroughbred foals (2017-2023) with necropsy-confirmed complete AVSD and summarized their clinical presentation, transthoracic echocardiographic findings, and postmortem anatomy. All foals showed early signs of congenital cardiac disease including weakness, failure to thrive and cardiac murmurs. Echocardiography demonstrated a common atrioventricular junction with a single atrioventricular valve and combined atrial and ventricular septal defects; all were classified as Rastelli type C. Postmortem examination confirmed a common atrioventricular valve with atrial and ventricular septal components in each foal. Despite variable age at presentation, all foals had marked cardiovascular compromise and prognosis was poor. Complete AVSD should be considered in foals with early-onset debilitation or murmurs, and transthoracic echocardiography provides a reliable antemortem diagnosis.

Papillary fibroelastoma (PFE) is a benign primary cardiac tumor arising from the endocardial surface, most commonly affecting the valvular endocardium. Although often incidental, PFEs may lead to serious complications, including systemic embolization, valvular obstruction, or regurgitation. Aortic valve fibroelastoma resulting in severe aortic insufficiency (AI) may be rare. A 77-year-old woman with a history of hypertension and chronic kidney disease presented with progressive dyspnea, orthopnea, and bilateral lower extremity edema. Examination revealed a diastolic murmur at the left lower sternal border. Transthoracic echocardiography demonstrated a tri-leaflet aortic valve with preserved left ventricular systolic function and moderate eccentric aortic regurgitation due to incomplete cusp coaptation. A transesophageal echocardiogram was performed, which revealed a small, filamentous, and mobile mass that was visualized at the base of the noncoronary cusp (NCC), consistent with a PFE. There were no clinical or laboratory findings suggestive of infection, and the lesion's morphology was inconsistent with vegetation. Holodiastolic flow reversal in the descending aorta confirmed severe AI. The patient was diagnosed with acute decompensated heart failure secondary to severe aortic regurgitation. After medical optimization, she underwent surgical aortic valve replacement. Intraoperative histopathology confirmed the presence of a fibroelastoma originating from the NCC. Postoperative recovery was uneventful, and the patient demonstrated marked symptomatic improvement. This case illustrates a rare presentation of PFE causing severe aortic regurgitation through mechanical interference with cusp closure rather than leaflet destruction. PFEs are typically small, avascular, and pedunculated, and when located near the coaptation zone, they can prevent complete leaflet closure, resulting in significant hemodynamic compromise. Echocardiography remains the diagnostic modality of choice, and multimodal imaging may aid in differentiating PFEs from vegetations or thrombi. Surgical excision is recommended for symptomatic, mobile, or left-sided PFEs due to the risk of embolization and valvular dysfunction. Although rare, PFE of the aortic valve should be recognized as a potential cause of severe AI. Early diagnosis and timely surgical management are curative and prevent embolic complications.

Unicuspid aortic valves (UAVs) are rare congenital anomalies associated with severe aortic stenosis (AS) in infancy or later adulthood. This is a case of a 22-year-old woman who presented with acute hypoxemic respiratory failure, which was initially attributed to multilobular pneumonia with acute respiratory distress syndrome. However, echocardiography revealed UAV with severe stenosis, suggesting cardiogenic pulmonary edema. The patient underwent successful surgical aortic valve replacement. This case highlights that the diagnosis and management of UAVs is tenuous: cases are prone to rapid decompensation, such as flash pulmonary edema, with acute hemodynamic changes, such as aggressive intravenous fluid administration. There currently exist no guidelines specific to UAVs, but diagnosis and management can be extrapolated from bicuspid aortic valves presenting with severe stenosis. Congenital valvulopathies should be considered in young adults with a heart murmur accompanied by exercise intolerance. Complex pre-existing cardiopulmonary hemodynamics necessitate a holistic approach to the management of acute conditions like pulmonary edema in this cohort.

Background and Objectives: Acute respiratory distress syndrome (ARDS) carries high mortality, with cardiovascular complications frequently contributing to adverse outcomes. This study investigated the relationship between cardiac auscultation using electronic stethoscopy and echocardiographic findings and evaluated their prognostic significance in mechanically ventilated ARDS patients. Materials and Methods: This prospective observational study enrolled 173 consecutive adults with ARDS requiring mechanical ventilation (June 2020-June 2021). Cardiac auscultation was performed using an electronic stethoscope at four standard valvular positions. Bedside echocardiography assessed ventricular function, valvular regurgitation, right ventricular systolic pressure (RVSP), and inferior vena cava dimensions. Primary outcomes were ICU and 90-day mortality; the secondary outcome was ICU length of stay. Results: ICU mortality was 42.2% and 90-day mortality 46.8%. Auscultation findings correlated significantly with echocardiographic parameters: aortic stenosis murmur with an elevated aortic valve velocity (p = 0.009), and mitral/tricuspid regurgitation murmurs with corresponding color Doppler findings (p < 0.001). In multivariate analysis, the mean daily SOFA score (OR 2.39, 95% CI 1.57-3.64, p < 0.001) and RVSP (OR 1.07, 95% CI 1.02-1.11, p = 0.006) independently predicted ICU mortality. For 90-day mortality, the APACHE II score (OR 1.25, p = 0.006), mean daily SOFA score (OR 1.54, p = 0.039), RVSP (OR 1.07, p = 0.020), and mitral regurgitation severity (OR 2.98, p = 0.031) were independent predictors. ICU length of stay was predicted by the mean daily SOFA score (r = 0.35, p < 0.001) and tricuspid regurgitation severity (r = 0.25, p = 0.012). Conclusions: Electronic stethoscope auscultation correlates with the echocardiographic findings in ARDS patients. The RVSP and SOFA scores independently predict mortality, while valvular regurgitation severity provides additional prognostic information for long-term survival and ICU resource utilization.

Cardiovascular (CV) disease is the leading cause of mortality in systemic lupus erythematosus (SLE). The risk of myocardial infarction (MI) in SLE is twice the incidence and ten years earlier in onset than in the general population. We present the first known case in the Philippines of acute MI from triple vessel coronary artery disease (CAD) in a young female patient with SLE. This aims to increase recognition and improve preventive strategies for this rare lupus complication. A 31-year-old female with SLE for thirteen years, antiphopspholipid syndrome (APS) and controlled hypertension (HTN) presented with acute chest pain, diaphoresis, and dyspnea. She was a non-smoker with quiescent lupus and nephritis, maintained on low-dose aspirin, mycophenolate mofetil and hydroxychloroquine for the past four years. The physical examination revealed hypertension, bradycardia, normal heart sounds without murmurs, and no signs of lupus flare. The troponin level was elevated, and the electrocardiogram showed inferior wall ST-segment elevation myocardial infarction (STEMI). Coronary angiography revealed triple-vessel disease, with 80-90% stenosis of the left circumflex artery, and total occlusion of the left anterior descending and right coronary artery. There were segmental wall motion abnormalities and a low ejection fraction of 44% on echocardiography. The complete blood count, urinalysis, and serum C3 were within normal range. The anti-dsDNA was low and lipid levels were abnormal. The patient refused coronary artery bypass grafting (CABG). Medical management consisting of anti-platelets, betablockers, statin, and warfarin was maximized. The patient completed one year of follow-up without any lupus flares or cardiovascular events. This case illustrates the complex interaction of diseaserelated and traditional cardiovascular risk factors leading to premature coronary artery disease in a young female with SLE. The case demonstrates favorable one-year outcomes after optimized post-MI medical management. Aside from optimized lupus control and reduced glucocorticoid use, proactive screening and aggressive management of modifiable CV risk factors and antiphospholipid antibodies (aPL), are necessary.

As part of wildlife conservation efforts, the reintroduced Eurasian lynx (Lynx lynx) populations in Switzerland are the subject of ongoing health surveillance. Cardiac pathologies, such as heart murmurs and histopathologic changes in the cardiac tissue, including intramural cardiac vessels, are frequently observed. Here we describe four cases of subaortic stenosis (SAS), a congenital heart disease rarely reported in felids, in free-ranging adult male lynx from Switzerland. The affected lynx presented macroscopically with grades 1 to 3 of SAS. Histopathology confirmed characteristic subvalvular fibrous tissue as well as myocardial fibrosis and arteriosclerosis. Clinical data for one lynx, including the documentation of a systolic heart murmur, provide further case-specific insights. Our findings suggest that SAS might be linked to the recurrently noted cardiac pathologies and could be associated with the low genetic variability of lynx in Switzerland. This highlights the importance of integrating health and genetic data into conservation strategies to preserve healthy, viable wildlife populations.

A heart murmur is a key indicator of cardiovascular disease, making auscultation essential. Nonetheless, its accuracy is influenced by the clinician’s experience and subjective interpretation. This study developed a deep learning–based algorithm (CNN6) for automated detection of heart murmurs using phonocardiogram (PCG) data acquired via a digital wireless stethoscope. A total of 2,269 recordings (over 20 h) from 406 dogs were used for model development and validation, and 297 recordings from 60 dogs were reserved for independent testing. The model achieved 89.9% sensitivity, 92.7% specificity, and 90.9% accuracy, demonstrating diagnostic performance comparable to that of experienced veterinarians. This AI-assisted approach provides a consistent and objective murmur assessment and represents a clinically applicable screening tool for myxomatous mitral valve disease (MMVD), enhancing diagnostic precision, facilitating telemedicine, and promoting the integration of artificial intelligence into veterinary cardiology.