Dilated Cardiomyopathy

Abstract

A 42-year-old woman presented herself to the emergency services in cardiogenic shock. She had a history of progressively worsening breathlessness for the past year; however, no medical evaluation had been performed earlier. At presentation, her pulse rate was 110 beats per minute, regular, and low volume, and her blood pressure was 90/70 mm Hg. On auscultation, third heart sound was present, but no murmurs were heard. Soon after presentation, she had an asystolic cardiac arrest. However, she was resuscitated successfully and mechanically ventilated, and she required inotropic support with dopamine and noradrenaline for maintaining blood pressure. Her ECG showed normal sinus rhythm and nonspecific ST-T changes, and chest radiograph showed cardiomegaly with features of pulmonary venous hypertension (Figure 1). Her echocardiogram showed severe left-ventricular systolic dysfunction with a left-ventricular ejection fraction of 20% (Figure 2). Her routine blood biochemistry, including liver and renal function tests, was within normal limits, except for mild anemia with hemoglobin of 9.5 g/dl. A diagnosis of dilated cardiomyopathy …