In this blog post, we have compiled the key highlights from the session titled “My Dog Suddenly Fainted While Walking in the Park! Cardiology Emergencies”, presented by Prof. Dr. Yücel Meral, held as part of VetSummit 2025: New Horizons in Veterinary Clinical Sciences, sponsored by the Kito Healthy Pet Nutrition Ecosystem. We would like to thank our speaker for the presentation.
The Fear of ECG in Veterinary Cardiology: Life-Saving Knowledge in 30 Seconds in the Field
In veterinary medicine, there are topics that feel “difficult and distant” in school but become immediate reality once you enter clinical practice. Cardiology is exactly one of those fields. Heart disease does not always progress as a “slow process.” Sometimes a patient arrives and you truly have only 30–40 seconds. Is the heart beating? Is the rhythm lethal? Where should intervention begin? All of that must be determined within that time frame.
Prof. Dr. Yücel Meral’s talk in Session 6 of New Horizons in Veterinary Clinical Sciences focused precisely on this reality. Rather than presenting cardiology as a pile of theory, he explained it as a clinical discipline that must become an instinctive reflex.
The main message was clear:
“You cannot say you examined the heart without an ECG. Some nights, your only chance is the ECG.”
1) The Heart Is Not Just a “Pump”—It Is a Self-Operating Muscular System
The first misconception that must be corrected is this:
The heart is not a simple pump. It is a miraculous muscle system that operates on its own, controlled by the autonomic nervous system. It beats 60–100 times per minute (or even more in some species), carrying the entire body’s oxygen, nutrient, and waste circulation.
That is why even a small electrical disturbance can rapidly turn into collapse affecting breathing, circulation, and the brain within minutes. Once you recognize this in real cases, cardiology stops being “a difficult subject” and becomes “the foundation that holds life.”
2) Cardiology Is Not a One-Device Job: The Logic of “Holistic Cardiology”
Prof. Meral presented an excellent framework: cardiac evaluation cannot be completed with a single method:
- ECG: electrical conduction and rhythm
- Echocardiography: structure, valves, chambers, flow
- Radiography: cardiac size and pulmonary impact
- Angiography / CT: vessels and advanced imaging
He describes combining these as holistic cardiology, because in real clinical cases, you often need to press more than one button at the same time.
3) The First Question in Emergency Medicine: “Is the Heart Beating?”
When a patient arrives after fainting, the reflex in many clinics is:
“Let’s take an X-ray, let’s do an echo.”
But the speaker’s warning is clear:
Every step that wastes time can cost a life.
That is why the fastest and most practical tool in the field is the ECG.
Within seconds, an ECG tells you:
- Is the heart beating?
- Is the rhythm regular or irregular?
- Is this rhythm potentially fatal?
Even this information alone can guide you toward the correct intervention.
4) A Fearless ECG Reading Sequence (Because Without a Sequence, There Is Chaos)
ECG lines are not difficult—the difficult part is not having a structured approach.
Instead of a list of rigid rules, the speaker described a fixed sequence that works in real-life emergency settings:
1. Is the rhythm regular?
If RR intervals are equal, it is regular.
2. What is the heart rate?
For regular rhythms, use the large-box method:
-
- RR interval = 3 large boxes → 300/3 = 100 bpm
- 2 large boxes → 150 bpm
- 1 large box → 300 bpm
3. Is there a P wave, and does every P lead to a QRS?
This helps evaluate atrial–ventricular conduction.
4. Is the QRS complex wide or narrow?
A wide QRS is an alarm sign for ventricular origin.
5. What does the ST–T segment show?
-
- ST elevation or depression → consider ischemia/infarction
- T wave changes → electrolyte, oxygenation, or conduction abnormality warning
With this sequence, ECG interpretation becomes a clinical language rather than a confusing image.
5) “Killer Patterns”: ECG Findings That Require Immediate Action
This was the most critical part of the seminar. The speaker emphasized clearly that these are lethal ECG patterns.
If you see anything other than normal sinus rhythm—such as:
- ventricular tachycardia
- ventricular fibrillation
- atrial flutter / atrial fibrillation
- supraventricular tachycardias
- torsades de pointes
- asystole (a flatline)
then the ECG is no longer a diagnostic step—it becomes the button to start intervention.
Because death may follow.
6) The First Move: Vagal Maneuvers—Simple but Sometimes Shockingly Effective
A step often overlooked in veterinary practice but reflexive in human medicine: vagal maneuvers.
The speaker demonstrated this with a live example:
In an SVT patient, a correct vagal maneuver can reduce the rhythm from 180–200 bpm down to 90–100 bpm.
The most practical method in veterinary practice:
Carotid artery massage / gentle stroking
Can be used in many species and may lower rhythm within seconds.
Oculocardiac reflex (gentle pressure on the eyes)
Applying pressure for 15–20 seconds can cause a dramatic reduction in heart rate.
Even if the success rate is only 30–40%, in critical moments this is the cheapest and fastest chance available.
7) If Vagal Maneuvers Fail: The “Lidocaine Reflex” in the Field
Here, the speaker spoke directly from real practice:
“Lidocaine is my favorite—I apply it immediately.”
The logic is practical:
- inexpensive
- available in most clinics
- quick response in acute tachycardia
Administration:
- bolus or infusion
- ECG monitoring
- you can literally watch the rhythm drop in real time
After stabilization, options like diltiazem or beta-blockers can be considered.
However, a critical warning was emphasized:
Because of hypotension risk, medications should never be given blindly without blood pressure monitoring.
8) Adenosine = “Resetting the Heart”
The speaker described adenosine as a “turn-off and restart” mechanism because it:
- blocks the SA–AV node for 8–10 seconds
- the heart briefly stops
- then the system restarts
- the goal is a return to sinus rhythm
If there is no response, the dose is increased stepwise.
Although the effect may not be as predictable in animals as it is in humans, it can be life-saving in appropriate cases.
9) The Defibrillator Myth: It Is Not Only for Asystole
A defibrillator is not used only to “restart a stopped heart.”
Its primary role is in:
- ventricular fibrillation
- severe tachyarrhythmias
A correct shock can restore life within seconds.
And if the clinic does not have the device, the missing element is not only technology—it is preparedness culture.
Closing: Knowing ECG Means You Are Not Alone in the Field
The key reality this session left behind is this:
Cardiology is a vast world, but the ECG is the fastest survival language in that world.
Even if you know that language only at a basic level:
- panic decreases when a patient collapses
- you start intervention on time
- you reduce the risk of losing the patient in front of your eyes
And the simplest yet most life-saving question in the clinic is:
“What is the heart doing right now?”
A clinician who can read the answer through ECG moves cardiology out of the realm of fear and into the realm of reflex.
We will continue sharing key highlights from the sessions of VetSummit 2025: New Horizons in Veterinary Clinical Sciences, sponsored by the Kito Healthy Pet Nutrition Ecosystem. See you in our upcoming content that will support your clinical practice.
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