A Case of Congenital Pulmonary Vein Stenosis with Secondary Post-Capillary Pulmonary Hypertension and Left Sided Congestive Heart Failure in a Cat

Abstract

A five-month-old, 3.8 kg intact male Maine coon cat presented for dyspnea characterized by increased respiratory effort in addition to open-mouth breathing. Thoracic radiographs showed pectus excavatum, enlarged cardiac silhouette, and generalized interstitial patterns. Echocardiography revealed normal left atrial (LA) and left ventricular dimensions. A large tubular structure, suspected to be a distended pulmonary vein (PV), was identified as draining into the LA. Severe eccentric and concentric right ventricular hypertrophy and paradoxical septal motion were noted. Based on Doppler echocardiography, both pulmonary venous and pulmonary artery pressure was severely elevated. Clinical, radiographic, and echocardiographic abnormalities were hypothesized to result from pulmonary vein stenosis (PVS), causing severely elevated pulmonary venous pressures and resulting in clinical signs of left-sided congestive heart failure (L-CHF) and severe post-capillary pulmonary hypertension (Pc-PH). The prognosis for good quality of life was assessed as poor, and the owner elected euthanasia. Necropsy confirmed the presence of PVS with severe dilation of the PVs draining all but the left cranial lung lobe. All lung lobes except the left cranial lobe had increased tissue density and a mottled cut surface. This case report shows that, in rare cases, both L-CHF and Pc-PH may be present without LA enlargement. To the authors’ knowledge, this is the first report on PVS in veterinary medicine.

Partial Pulmonary Vein Stenosis in a Cat Treated with Sildenafil: A Case Report

“…PVS is a rare cardiovascular disease; till date, only one veterinary case report of a Maine coon cat with congenital PVS confirmed using echocardiography and autopsy after ethical euthanasia has been reported [3]. PVS is a rare congenital or acquired cardiovascular disease, even in humans [5].…”

“…Pulmonary venous stenosis (PVS) is rare in cats and can lead to PH. However, only one previous study has reported a case of PVS and resultant PH in cats, and this diagnosis was obtained post-mortem [3]. Here, we report a case of feline PH secondary to congenital PVS and parenchymal lung disease detected using echocardiography and computed tomography (CT).…”

Influence of Clinical Aspects and Genetic Factors on Feline HCM Severity and Development

“…In this study, it was noted that all cats with severe HCM had increased left atrial diameter and prolonged isovolumic relaxation time. However, as one publication [23] showed, not all cases of left-sided heart failure may be manifested with left atrial and ventricular enlargement.…”