Dilated Cardiomyopathy: The Daily PANCE Blueprint

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Dilated Cardiomyopathy: The Daily PANCE Blueprint

A 71-year-old male with a history of chronic alcoholism presents to the ER with severe shortness of breath. Vitals reveal hypoxemia (SpO2 86% on RA). A CXR demonstrates increased pulmonary vascular congestion, bilateral infiltrates, and cardiomegaly. On physical exam, you appreciate elevated JVD and 2+ lower extremity edema. An echocardiogram shows LV dilation with a reduced ejection fraction of 40%. Which of the following is the most likely diagnosis?

A. Restrictive cardiomyopathy
B. Dilated cardiomyopathy
C. Hypertrophic cardiomyopathy
D. Takotsubo cardiomyopathy
E. None of the above

Answer and topic summary

The answer is B. Dilated cardiomyopathy

Dilated cardiomyopathy (DCM) is defined by enlargement of the ventricles with systolic dysfunction but normal LV wall thickness. Causes include genetics (25-30%), autoimmune (RA, sarcoidosis, scleroderma, etc.), infections (Chagas disease, HIV, mycobacteria), infiltrative diseases (amyloidosis), and nutritional issues (Kwashiorkor, thiamine deficiency), and other things like alcohol and chemo agents. Clinical features include dysrhythmias and typical symptoms of heart failure. Diagnosis is confirmed with an echocardiogram. Patients should be given guideline-directed medical therapy for heart failure (e.g., ACEI/ARB, BBs, diuretics, etc…).

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Smarty PANCE Content Blueprint Review:

Covered under ⇒ PANCE Blueprint Cardiology ⇒ Cardiomyopathy (PEARLS)⇒ Dilated Cardiomyopathy

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