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A 3-year-old, 4-kg, castrated male domestic shorthair cat presented with signs of progressive respiratory distress. Thoracic radiographs showed pulmonary edema and pleural effusion. Echocardiography revealed a perforate membrane immediately above the mitral valve that divided the left atrium into proximal and distal chambers. The left auricle was proximal to the dividing membrane and connected to the markedly enlarged proximal left atrial chamber, consistent with the diagnosis of supravalvular mitral stenosis (SMS). Position of the obstructing membrane relative to the left auricle distinguishes SMS from cor triatriatum sinister (CTS). In CTS, the left auricle is distal to the dividing membrane and connects to the distal left atrial chamber.
J Am Anim Hosp Assoc 2002;38:403-406.
Case Report
A 3-year-old, 4-kg, castrated male domestic shorthair cat was presented to the University of Minnesota Veterinary Teaching Hospital (UMVTH) for evaluation of respiratory distress. The cat had a 1-month history of labored breathing and intermittent coughing. His appetite had been decreased for the previous month, and he had been completely anorectic for several days prior to presentation.
On physical examination, the patient was quiet, alert, and responsive. He was in normal body condition. Respiratory rate was 100 breaths per minute, with increased inspiratory and expiratory effort. Lung sounds were muffled on auscultation, though an expiratory wheeze could be heard when he became agitated. Heart rate was 180 beats per minute and regular. A grade 3/6 holosystolic murmur with point of maximal intensity over the left caudal parasternal region could be heard. All other physical examination findings were normal.
Thoracic radiographs showed moderate pleural effusion and a severe, diffuse alveolar infiltrate. The cardiac silhouette was somewhat obscured by the fluid but appeared moderately to severely enlarged relative to the thorax.
Thoracocentesis was performed, and 165 mL of slightly hemorrhagic, milky effusion was removed. Fluid analysis revealed 11.6 x 10^sup 3^ nucleated cells/pL, 17.4 x 10^sup 3^ red blood cells/(mu)L, and a total protein of 3.2 g/dL. The nucleated cells were 95% normal small lymphocytes and 5% macrophages. Abundant extracellular lipid droplets consistent with chylomicrons were present. The fluid was not evaluated for cholesterol and triglyceride concentrations, as the visualization of chylomicrons on microscopy is considered specific for chylous effusions.1 A complete blood count was within reference ranges. A serum...