Dilated cardiomyopathy - guidelines for personalization of care

Area of Science:

• Cardiology
• Genetics
• Psychiatry

Background:

• Dilated cardiomyopathy (DCM) involves genetic and environmental factors.
• Cardiac magnetic resonance imaging aids etiological diagnosis and treatment.
• Sudden cardiac death (SCD) is a risk in DCM, especially with family history.

Purpose of the Study:

• To present a challenging case of DCM in a young male with complex comorbidities.
• To discuss the etiological investigation and therapeutic decision-making process.
• To evaluate defibrillator options for SCD risk management in this patient.

Main Methods:

• Case report of a young male patient with DCM, severe left ventricular dysfunction, and a family history of SCD.
• Consideration of etiological factors including psychiatric pathology and substance addiction.
• Evaluation of wearable defibrillator versus subcutaneous implantable cardioverter-defibrillator (SCD-ICD) for SCD prevention.

Main Results:

• The patient presented with DCM, significant ventricular dysfunction, and SCD risk.
• Psychiatric conditions and potential non-adherence precluded the use of a wearable defibrillator.
• A subcutaneous defibrillator was implanted, representing a personalized therapeutic strategy.

Conclusions:

• Personalized therapeutic choices are crucial in complex DCM cases.
• Subcutaneous defibrillators offer an alternative for SCD prevention when adherence to other devices is a concern.
• Multidisciplinary management is essential for patients with DCM and co-existing conditions.