‘Hot phase’ non‐dilated left ventricular cardiomyopathy with atypical onset and recurrence: a case report

Author:

Gonano Nicola12,Nuzzi Vincenzo3,Pavan Daniela2,Piazza Rita2,Pecoraro Rosa2,Altinier Alessandro1,Bussani Rossana4,Sinagra Gianfranco1,Merlo Marco1

Affiliation:

1. Department of Cardiothoracovascular, Azienda Sanitaria Universitaria Integrata Giuliana Isontina (ASUGI) University of Trieste Trieste Italy

2. Department of Cardiology, Santa Maria degli Angeli Hospital Azienda Sanitaria Friuli Orientale (ASFO) Pordenone Italy

3. Clinical Cardiology and Heart Failure Unit Mediterranean Institute for Transplantation and Advanced Specialized Therapies (ISMETT) Palermo Italy

4. Institute of Pathological Anatomy and Histology, Azienda Sanitaria Universitaria Giuliano‐Isontina (ASUGI) University of Trieste Trieste Italy

Abstract

AbstractNon‐dilated left ventricular cardiomyopathy (NDLVC) is a newly categorized cardiomyopathy phenotype includingseveral aetiologies with a linking characteristic represented by the normal left ventricular volume. Inflammatory heart disease (InHD) is a heterogeneous process with variegate clinical manifestations, sometimes in overlap with NDLVC. A 26‐year‐old woman was admitted forcomplete heart block (CHB) and persistently raised troponin. Echocardiography and coronary angiography were normal. Extensive oedema and late gadolinium enhancement was found at cardiac magnetic resonance. Endomyocardial biopsy showed no signs of active myocarditis. Steroid therapy was started with restoration of atrioventricular conduction but subsequently the patient experienced a mild recurrence with a new troponin relapse. Genetic test was negative for mutations related with the clinical scenario. In this case of NDLVC with InHD the precise diagnostic work‐up, including genetic test, was crucial for diagnostic, prognostic andtherapeutic purposes. Multimodality approach is crucial to detect and treat possible recurrences.

Publisher

Wiley

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