A 6-month-old mature intact female Siamese cat presented with exertional dyspnea. Diagnostic studies revealed pleural effusion, grade 4/6 left basal systolic murmur, deep S-wave in electrocardiograph leads I, II, and III, cardiomegaly with pleural effusion on radiography, pulmonic systolic (~5.8 m/sec) and tricuspid (3.6 m/sec) regurgitant jets, atrial septal defect, and a hypoplastic right outflow tract. Based on these results, the case was diagnosed as pulmonic stenosis with atrial septal defect. To the best of our knowledge, this is the first case report describing pulmonic stenosis with atrial septal defect in a cat in Korea.Keywords: right ventricular outflow tract obstruction, pulmonic stenosis, pulmonic valve dysplasia, congenital heart defect, cat Pulmonic stenosis (PS) is a congenital heart defect in which the right ventricular outflow tract (RVOT) is obstructed by either/both pulmonic valvular deformities or/and narrowing of RVOT (i.e., hypoplastic RVOT) [7,9]. Although the most PS cases in human and veterinary literatures are isolated defect, the some PS cases are often occurred with other defects such as atrial septal defect (ASD), ventricular septal defect and tetralogy of Fallot [7]. The PS is largely divided into subvalvular, valvular or supravalvular, depending on the location of obstruction [4,7]. Clinical consequences of symptomatic PS include left basal systolic murmur and right side heart failure accompanied with marked tricuspid insufficiency [9]. One recent retrospective study found the prevalence of PS was ~10% (16/162) in feline congenital heart defects [10]. ASDs are abnormal communications between right and left atria and are generally occurred from congenital heart defects in which the atrial septum formed incompletely. The secondary ASDs can be also occurred from secondary to severe pulmonary or left atrial (LA) dilation [7]. This case report describes a rare case of PS by hypoplastic RVOT with secondary ASD in a Siamese cat.A 6-month-old intact female Siamese cat (2.3 kg of body weight) was presented with primary complaints of loud heart murmur, exertional dyspnea and exercise intolerance. In physical examination, the cat had grade IV/VI left basal systolic murmur. The mucosa in lips was pink and moist. Systolic blood pressure measured by a Doppler detector (811B; Parks Medical Electronics, USA) was 100 mmHg. Electrocardiography (ECG) studies revealed normal sinus rhythm with right ventricular enlargement (presence deep S-wave in lead I, II and III) and sinus bradycardia (80−95 beats per min; Fig. 1). Complete blood cell count and serum chemistry profiles have no significant abnormalities.Thoracic radiography revealed marked pleural effusion with loss of cardiac silhouette and retracted caudal lung lobes. Thoracocentesis was performed at right side of chest and removed 350 mL blood tinged fluid. Cytological examination found red blood cells and mononuclear cells, suggesting modified transudate. Further thoracic radiography after removal of pleural effusion revealed cardiome...