Winter RL, Jennings RN, Cronin JP, Rhinehart JD, Schober KE. Acquired left-to-right shunting through a valve-incompetent foramen ovale in a cat with hypertrophic cardiomyopathy and congestive heart failure.
JFMS Open Rep 2020;
6:2055116920959607. [PMID:
33062291 PMCID:
PMC7536497 DOI:
10.1177/2055116920959607]
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Abstract
Case summary
An 8-year-old spayed female domestic shorthair cat was presented for a recheck
evaluation of hypertrophic cardiomyopathy and chronic kidney disease. Three years prior
to presentation, the patient was diagnosed with obstructive hypertrophic cardiomyopathy
and started on atenolol. The left ventricular outflow tract obstruction subsequently
resolved. Biochemical analysis a week prior to presentation demonstrated severe
azotemia. Transthoracic echocardiograph revealed pericardial effusion, pleural effusion,
severe left ventricular concentric hypertrophy, severe left atrial enlargement and
continuous left-to-right flow through the interatrial septum near the fossa ovalis. The
patient was euthanized owing to poor prognosis, and gross examination at necropsy
revealed a valve-incompetent patent foramen ovale secondary to severe left atrial
dilation.
Relevance and novel information
To our knowledge, this is the first report of an acquired left-to-right shunt through a
valve-incompetent foramen ovale in a cat with hypertrophic cardiomyopathy. Severe left
atrial dilation was suspected to cause interatrial shunting through the
valve-incompetent foramen ovale, and this finding may be relevant to echocardiographic
evaluations in other cats.
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