Inka was referred with the chief complaints of dyspnea, tachypnea, and events believed to be syncope. The first and second syncopal events were noted 10 and 3 months prior to presentation, respectively, while she has experienced 3 such events in the past month associated with excitement. Tachypnea (rates up to 85 breaths per minute) and dyspnea have been intermittently noted for the past month. Therapy with benazepril (5mg once daily) was initiated 2 weeks prior to presentation by the referring veterinarian (RDVM), which seemed to help her breathing initially. Most recently, however, Inka has been unable to sleep in lateral recumbency (orthopneic) and has begun non-productive retching over the last 2-3 days. Her owner stated that Inka does not normally exercise, so the presence or absence of exercise intolerance could not be assessed.