Cardiogenic Shock in a Young South Asian Male With Cardiomyopathy due to a Pathogenic Variant of BAG3 Gene

Dilated cardiomyopathy presenting acutely as cardiogenic shock in a young adult is an infrequent and life-threatening condition. We present a case of a 25-year-old South Asian male without any significant past medical history, presenting with complaints of nonspecific abdominal bloating and subacute cough. Upon presentation, he was in sinus tachycardia and found to have moderate right pleural effusion, which was urgently drained. His echocardiogram revealed an ejection fraction of 15%-20%. He quickly progressed into cardiogenic shock with prerenal acute kidney injury, acute congestive hepatopathy, pancreatitis, and hypoxic respiratory failure. He required pressors and noninvasive positive pressure ventilation. He was transferred to a tertiary center, where he was placed on a left ventricle assist device and eventually had a heart transplant. The search for the cause of this dramatic acute dilated cardiomyopathy revealed a mutation in Bcl-2-associated athanogene 3 (BAG3).