Idiopathic Dilated Cardiomyopathy Associated with Bicavitary Thrombi: Case Report, Diagnostic Approach and Literature Review

Abstract

Dilated cardiomyopathy is considered as a dysfunction of the left ventricle systolic function or even both ventricles associated with myocardial dilation. Approximately 50% of cases have an identifiable cause such as genetic mutations, infectious, autoimmune or metabolic diseases, among others. When the origin of dilated cardiomyopathy is not identified, it is considered idiopathic, which constitutes the other 50% of cardiomyopathies. The diagnostic approach is based on laboratory and image studies trying to identify the known causes of dilated cardiomyopathy, the treatment consists in those cases of known etiology cardiomyopathy in the treatment of the underlying disease as well as the heart failure if it presents, if the etiology is unknown we only focus in improve the symptoms caused by cardiomyopathy. We present a case of a 27-year-old man with history of sudden cardiac death in a second degree relative, who initially presented signs of heart failure with later pulmonary thromboembolism secondary to biventricular intracardiac thrombi. A complete diagnostic approach was performed, ruling out genetic and non-genetic causes of dilated cardiomyopathy, without being perform an endomyocardial biopsy to complete the diagnostic approach due to the risk that the procedure involved and the patient's refusal.