Dilated Cardiomyopathy Mimicking Arrhythmogenic Right Ventricular Cardiomyopathy in a 35-Year-Old Woman

Abstract

While dilated cardiomyopathy (DCMP) typically involves the left ventricle (LV), it can also impact the right ventricle (RV). Arrhythmogenic right ventricular cardiomyopathy is a heritable myocardial disorder that mainly affects the RV. A 35-year-old woman presented to the emergency department complaining of chest discomfort and palpitations. The patient had ingested 100 g of alcohol daily for more than 5 years. Transthoracic echocardiography showed dilation of the four cardiac chambers with global systolic dysfunction of the prominent myocardial recesses of both ventricles. Non-sustained ventricular tachycardia was observed on 24-hour Holter monitoring. On magnetic resonance imaging (MRI), the ratio between noncompacted and compacted layers did not meet the criteria for non-compaction, and delayed gadolinium enhancement was only observed in the inferior LV myocardium. Endomyocardial biopsy revealed no fibrosis or fatty changes. Consequently, a diagnosis of alcohol-induced DCMP was reached. Various diagnostic modalities, including MRI and biopsy, can contribute to accurate diagnoses.