The patient initially presented for an echocardiogram due to a heart murmur found during a routine wellness exam. An echocardiogram revealed a ventral septal defect. At a 4-month recheck echo, the patient was experiencing lethargy and labored breathing. Medications at that time were enalapril and furosemide. At a follow up echo a little over 4 months later, the patient presented again for labored breathing and continued lethargy. A few days prior, the patient had undergone a thoracocentesis in which a large amount of clear pleural effusion was aspirated from the chest. Current medications were vetmedin, furosemide, and clopidogrel.
