Case Report: Concurrent atrial and ventricular septal defect in a young Sphynx cat.

Concurrent ASD and VSD with Eisenmenger physiology in cats is rare and challenging to manage.

A 7-month-old intact female Sphynx cat presented with respiratory distress and exercise intolerance. Thoracic radiographs revealed generalized cardiomegaly and pulmonary infiltrates, indicative of cardiogenic pulmonary edema. Transthoracic echocardiography identified an ostium secundum-type atrial septal defect (ASD) and a perimembranous ventricular septal defect (VSD), with structurally normal atrioventricular valves and annuli, confirming concurrent ASD and VSD. Color Doppler echocardiography and agitated saline contrast studies demonstrated bidirectional shunting at both defect sites. Echocardiographic findings also suggested pulmonary hypertension. Given the suspicion of Eisenmenger syndrome and the owner's decision against invasive intervention, surgical repair was not performed. Initial treatment with furosemide and supplemental oxygen led to clinical improvement. Approximately 8 months later, the cat developed cyanosis and erythrocytosis. Follow-up imaging and Doppler echocardiography showed reduced cardiac silhouette size without recurrent pulmonary edema, right-sided chamber enlargement with right ventricular hypertrophy, and a decreased pulmonary-to-systemic flow ratio, consistent with progression of Eisenmenger physiology. Medical management with phlebotomy, sildenafil, clopidogrel, and oxygen supplementation provided temporary stabilization; however, the cat eventually died approximately 1 year after diagnosis, likely due to disease progression and inconsistent therapeutic compliance. Postmortem examination confirmed both septal defects and marked right ventricular hypertrophy, consistent with ante-mortem imaging findings. Histopathological examination revealed pulmonary vascular remodeling and myocardial fibrosis, indicative of chronic pulmonary hypertension. This report represents the first documented case of concurrent ASD and VSD with Eisenmenger physiology in a cat, with long-term clinical follow-up and postmortem confirmation. ([frontiersin.org](https://www.frontiersin.org/journals/veterinary-science/articles/10.3389/fvets.2025.1684236/abstract?utm_source=openai))

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