Near missed reversible cardiomyopathy: The value of the electrocardiogram

Dilated cardiomyopathy is a devastating disease affecting the myocardium that is characterized by cardiac chamber dilatation with contractile function impairment in the absence of structural heart disease. The majority of cases are idiopathic; these patients have a poor outcome. However, identifying a reversible etiology and instituting appropriate intervention could reverse the disease process and result in complete recovery. An electrocardiogram is a simple, non-invasive and quick test that should be performed in each patient presenting with dilated cardiomyopathy. Failure to perform this test or misinterpreting its result could result in a tragic misdiagnosis of idiopathic cardiomyopathy, depriving the patient of a potentially curative intervention. Here, we report two cases of dilated cardiomyopathy caused by clinical conditions with recognizable ECGs. In both cases, the diagnosis was missed initially, delaying corrective interventions. These cases draw attention to the importance of performing and correctly interpreting ECGs in patients with dilated cardiomyopathy.