Ernie, the 11 year old male Airdale terrier with asymptomatic mitral valve disease diagnosed 4 years ago had been enjoying life with prophylactic medication for his condition.
However, he presented to our emergency service during the recent Easter weekend with sudden onset lethargy in the evening. He had been his normal self during the day but now his tail was down and his head was hanging low. The owner also noticed his heart was pounding unusually fast on his chest.
An electrocardiogram showed very fast supraventricular tachycardia (SVT) at a rate of 250-270 bpm (figure 1).
250-270 bpm (figure 1)
A slow intravenous injection of the fast-acting beta-blocker esmolol converted the tachycardia into normal sinus rhythm at 110-120 bpm (figure 2). After close monitoring of his rate and rhythm with telemetry, Ernie was discharged home the same evening on oral anti-arrhythmic medication.
110-120 bpm (figure 2)
He slept soundly that night but in the morning he was his usual boisterous self barking at the postman.
Two days later he was seen for a follow-up assessment and his heart rate and rhythm remained normal. After a follow-up echocardiogram, slight adjustments on his therapy were made but we hope he continues to enjoy good quality of life for the foreseeable future.