Clin Ultrasound.  2022 Nov;7(2):118-123. 10.18525/cu.2022.7.2.118.

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

Affiliations
  • 1Department of Internal Medicine, Asan Medical Center, Seoul, Korea
  • 2Department of Internal Medicine, Bundang Jesaeng General Hospital, Seongnam, Korea
  • 3Department of Radiology, Kangbuk Samsung Hospital, Seoul, Korea
  • 4Department of Radiology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea

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.

Keyword

Arrhythmia; Ventricle; Alcohols; Cardiomyopathy; Dilated
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