Signalment: 9 years, FS, Birman
Presenting Complaint: Anorexia for 3 days and respiratory distress.
Presenting History

Lateral view

DV view

Lateral View:
	Evidence of Chamber Enlargement learn more
		Left Ventricle: No
		Right Ventricle: Yes    The cardiac silhouette is three intercostal spaces wide. Normally it is not more than 2.5 intercostal spaces wide
		Left Atrium: No
		Right Atrium: No
		Left Auricle: Indeterminate    This projection is not ideal to assess the size of the left auricle.
		Right Auricle: No
	Abnormalities of Great Vessels learn more
		Aortic Dilation: No
		Main Pulmonary Artery Dilation: No
		Caudal Vena Caval Enlargement: No
	Pulmonary Venous Distention learn more: No
	Airway Changes learn more
		Peribronchial Pattern: Yes    Profound airway markings
	Alveolar Changes learn more
		Air Bronchograms: No
		Cotton-like Densities: No
		Lobar Sign: No
	Pleural Effusion learn more
		Fissure Lines: No
		Leafing of Lung Lobes: No
	Pulmonary Edema learn more: No
	Evidence of Heartworm Disease learn more: No
	Other Findings
		Enlarged pulmonary arteries.
	Radiographic Diagnosis
		Severe peribronchial changes and pulmonary artery enlargement
	Description
		This projection is noteworthy because of the profound airway markings present diffusely throught out the lung fields. The pulmonary arteries are much larger than the corresponding pulmonary veins. The right side of the heart may well be enlarged.

DV View:
	Evidence of Chamber Enlargement learn more
		Heart too Wide: Yes    The horizontal greatest width should not exceed 50% the size of the chest within the pleural space.
		Left Ventricle: No
		Right Ventricle: Yes    The area of the right ventricle is very prominent
		Left Atrium: No
		Right Atrium: Yes
		Left Auricle: No
		Right Auricle: Indeterminate    This projection is not ideal to assess the size of the right auricle.
	Abnormalities of Great Vessels learn more
		Aortic Dilation: No
		Main Pulmonary Artery Dilation: Yes    There is a prominent bulge in the area of the main pulmonary artery
		Caudal Vena Caval Enlargement: No
	Pulmonary Venous Distention learn more: No
	Airway Changes learn more
		Peribronchial Pattern: Yes    There are prominent airway markings present.
	Alveolar Changes learn more
		Air Bronchograms: No
		Cotton-like Densities: No
		Lobar Sign: No
	Pleural Effusion learn more
		Fissure Lines: No
		Leafing of Lung Lobes: No
	Pulmonary Edema learn more: No
	Evidence of Heartworm Disease learn more: Indeterminate    These findings are quite consistent with heartworm disease (the presence of prominent pulmonary artery enlargement, and tortuous pulmonary arteries). There is no evidence of truncated pulmonary arteries.
	Other Findings
		Prominent enlarged and tortuous pulmonary arteries
	Radiographic Diagnosis
		Peribronchial changes with pulmonary artery enlargement
	Description
		This projection is quite impressive for the prominent enlarged and tortuous pulmonary arteries and the marked peribronchial changes.

Clinical Diagnosis   Feline Asthma with pulmonary artery hypertension

Comment   This cat underwent a cardiac ultrasound exam. This revealed profound pulmonary artery hypertension (estimated pulmonary artery systolic pressure of more than 150 mmHg [normal is up to 25 mmHg]). The right atrium and right ventricle were very enlarged. The left side of the heart was normal. There was no evidence of heartworm on the echocardiogram nor on serology.

The right sided changes are believed to be secondary to the feline asthma (cor pulmonale). We cannot exclude the potential that she has undergone one or many pulmonary thromboembolic events although no blood clots were observed in the right heart.