Arq. Bras. Cardiol. 2017; 109(2): 169-174

Case 4/2017 – Young Male Marathoner with Heart Failure Due to Dilated Cardiomyopathy

Hilda Sara Montero Ramirez, Rafael Amorim Belo Nunes, Vera Demarchi Aiello

DOI: 10.5935/abc.20170124

Clinical aspects

The patient was a 22-year-old male marathoner with fatal heart failure for 1 year. The clinical data reported were dyspnea and precordial discomfort on exertion. The patient maintained his trainings and running practice less intensely due to lower limb pain and weakness in the last months, until he was hospitalized due to chest pain, dyspnea, hemoptysis, mental confusion and syncope. During hospitalization, his clinical findings rapidly and progressively deteriorated. His electrocardiogram on admission revealed signs of right atrial overload, left ventricular overload and secondary ventricular repolarization changes. The left ventricle was diffusely hypokinetic and the diastolic function pattern was restrictive. There was moderate mitral and tricuspid valve regurgitation. These findings suggest cardiomyopathy with important hemodynamic repercussion.

The causes of cardiomyopathy in young individuals are: idiopathic cardiomyopathy, infectious myocarditis and autoimmune myocarditis. Cardiotoxicity can also be observed in exposure to certain agents, such as alcohol, cocaine, heavy metals and antineoplastic drugs, such as anthracyclines and cyclophosphamide.

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