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Dirofilaria immitis (Nematoda: Filarioidea) is the causative agent of heartworm disease (HWD), a severe and potentially fatal condition in dogs. Although cats are considered more resistant to infection than dogs, they are also susceptible to heartworm infection. Moreover, the clinical importance of feline dirofilariosis has increased in recent years, especially in heartworm endemic areas. In contrast to dog, definitive antemortem diagnosis of heartworm infection in cat is difficult to achieve and a combination of testing methods must be used for clinical confirmation. Here we describe a clinical case of heartworm infection in a 12-year-old male mixed breed cat, originated from Southern Romania, which was referred to a veterinary clinic with a history of vomiting and clinical signs of respiratory distress. The thoracic radiograph showed a diffuse bronchointerstitial pattern of the pulmonary parenchyma. The serological test for D. immitis circulating antibody was positive and heartworms were visualized by echocardiography in the main pulmonary artery. In conclusion, the present study clearly shows that cats are at risk for D. immitis infection in heartworm-endemic areas in Romania. Additionally, the findings highlight the urgent need for increased awareness among veterinary practitioners of the existence of feline heartworm diseases and for adequate prophylactic measures to be applied. To our knowledge, this is the first report on clinical evolution and radiographic and echocardiographic features of a naturally heartworm-infected cat in Romania. [ABSTRACT FROM AUTHOR]