While pulmonary disease is quite common in ruminants, cardiac disease is an uncommon finding and has not been previously reported in okapi (Okapia johnstoni). To date, there have been four known or suspected cases of cardiac abnormalities in okapi. Two of these cases have occurred in pregnant females at White Oak Conservation Center. These okapi presented with an increased respiratory rate, dyspnea, productive coughing, serous nasal discharge, lethargy, and decreased appetite. Both individuals had significant pleural fluid on ultrasonographic evaluation and suspected pulmonary edema. Echocardiographic evaluation of Okapi 1 indicated mild mitral valve regurgitation, an enlarged left atrium with hypertension and was tentatively diagnosed with congestive heart failure. Serum creatinine phosphokinase and serum troponin in this individual were also elevated. Both pregnant individuals responded with improved respiratory quality and rate when given parenteral furosemide and transitioned to oral dosing. The clinical signs observed in Okapi 1 resolved with treatment (oral furosemide, enalapril, and spirolactone), and she gave birth without complication to a clinically normal calf. At the time of this publication, Okapi 2 is responding to treatment (oral furosemide and enalapril) but is not as stable as Okapi 1 and has not yet given birth. The underlying etiology of the cardiopulmonary disease observed in these okapi has not been determined.