title: Reversible transition from a hypertrophic to a dilated cardiomyopathy.
abstract: We report the case of a 17-year-old female patient with known hypertrophic cardiomyopathy and a Wolff-Parkinson-White syndrome. She came to our department for further evaluation of a new diagnosed dilated cardiomyopathy characterized by an enlargement of the left ventricle and a fall in ejection fraction. Clinically, she complained about atypical chest pain, arrhythmic episodes with presyncopal events, and dyspnea (NYHA III) during the last 6 months. Non-invasive and invasive examinations including magnetic resonance imaging, electrophysiological examinations, and angiography did not lead to a conclusive diagnosis. Therefore, endomyocardial biopsies (EMBs) were taken to investigate whether a specific myocardial disease caused the impairment of the left ventricular function. EMB analysis resulted in the diagnosis of a virus-negative, active myocarditis. Based on this diagnosis, an immunosuppressive treatment with prednisolone and azathioprine was started, which led to an improvement of cardiac function and symptoms within 3 months after initiating therapy. In conclusion, we show that external stress triggered by myocarditis can induce a reversible transition from a hypertrophic cardiomyopathy to a dilated cardiomyopathy phenotype. This case strongly underlines the need for a thorough and invasive examination of heart failure of unknown causes, including EMB investigations as recommend by the actual ESC position statement.
authors: Department of Cardiology Charité-University Medicine of Berlin, Campus Virchow Klinikum Berlin Germany.
authors: Frank
authors: F
authors: Spillmann
authors: Department of Cardiology Charité-University Medicine of Berlin, Campus Virchow Klinikum Berlin Germany.
authors: Uwe
authors: U
authors: Kühl
authors: Berlin-Brandenburg Center for Regenerative Therapies (BCRT)Charité-University Medicine of Berlin, Campus Virchow KlinikumBerlinGermany; Deutsches Zentrum für Herz-Kreislaufforschung (DZHK)-Standort Berlin/CharitéBerlinGermany.
authors: Sophie
authors: S
authors: Van Linthout
authors: Department of Cardiology Hospital Universitario Puerta de Hierro Madrid Spain.
authors: Fernando
authors: F
authors: Dominguez
authors: Department of CardiologyCharité-University Medicine of Berlin, Campus Virchow KlinikumBerlinGermany; IKDT-Institut kardiale Diagnostik und Therapie GmbHBerlinGermany.
authors: Felicitas
authors: F
authors: Escher
authors: IKDT-Institut kardiale Diagnostik und Therapie GmbH Berlin Germany.
authors: Heinz-Peter
authors: HP
authors: Schultheiss
authors: Department of CardiologyCharité-University Medicine of Berlin, Campus Virchow KlinikumBerlinGermany; Deutsches Zentrum für Herz-Kreislaufforschung (DZHK)-Standort Berlin/CharitéBerlinGermany; Department of CardiologyDeutsches Herzzentrum Berlin (DHZB)BerlinGermany.
authors: Burkert
authors: B
authors: Pieske
authors: Department of CardiologyCharité-University Medicine of Berlin, Campus Virchow KlinikumBerlinGermany; Berlin-Brandenburg Center for Regenerative Therapies (BCRT)Charité-University Medicine of Berlin, Campus Virchow KlinikumBerlinGermany; Deutsches Zentrum für Herz-Kreislaufforschung (DZHK)-Standort Berlin/CharitéBerlinGermany.
authors: Carsten
authors: C
authors: Tschöpe
keywords: Dilated cardiomyopathy; Hypertrophic cardiomyopathy; Transition of cardiomyopathy