[Severe left ventricular dysfunction caused by multivessel coronaropathy in a 27-year-old man at low risk of...

When chronic heart failure develops in a young adult without history of ischemic heart disease, differential diagnosis between coronary artery disease and idiopathic dilated cardiomyopathy may be difficult. We describe a case of chronic heart failure in a 27-year-old male, apparently due to a dilated cardiomyopathy on the basis of clinical and instrumental data. Subsequent coronary angiography showed a severe tri-vascular coronary artery disease. After coronary bypass surgery, clinical and echocardiographic examinations showed relevant improvement in left ventricular global and regional motion, thus demonstrating that the severe left ventricular impairment was of ischemic origin.