Valentine-shaped heart in the cat: what it means
7-year-old Maine Coon with a gallop rhythm and resting tachypnoea. On the VD view the cardiac base is widened and the silhouette takes on a Valentine heart shape, with a narrow apex.
What does this finding indicate?
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A. Right ventricular hypertrophy due to pulmonic stenosis
Right-sided enlargement rounds the right border of the silhouette; it does not widen the base symmetrically as described here.
B. Pericardial effusion
Pericardial effusion produces a globoid, rounded silhouette with sharp margins, not a wide base with a narrow apex. In cats, a very large globoid silhouette should also prompt consideration of peritoneopericardial hernia.
C. Biatrial enlargement, especially of the left atrium, typical of feline cardiomyopathies
Correct. Enlarged atria widen the cardiac base on the VD/DV view. It is common in HCM, RCM and other cardiomyopathies, but it does not indicate the type: confirm with echocardiography.
D. The normal aortic undulation of the geriatric cat
The redundant aorta of older cats forms a cranial mediastinal bulge, not a widening of the base at the level of the atria.
lightbulb Key takeaway
Radiography is insensitive for feline cardiomyopathy: concentric hypertrophy may not change the silhouette. In the dyspnoeic cat, point-of-care ultrasound (left atrial size, effusions) and NT-proBNP are more helpful early on; feline oedema has a variable distribution and is often accompanied by pleural effusion.
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Updated: October 31, 2026 · Educational content for veterinary professionals. It does not replace current clinical guidelines or the judgement of the attending veterinarian.