Dilated cardiomyopathy associated with cocaine use: clinical case and review

Abstract

Case presentation. A 33 year old male patient, with recently diagnosed hypertension and chronic cocaine use, presented with symptoms of congestive heart failure. He underwent an echocardiogram that reported dilatation of all four cardiac chambers and decreased left ventricular ejection fraction. The etiology of the dilated cardiomyopathy was investigated, and infectious causes were ruled out. Treatment. The patient was managed in the acute phase with diuretics, dobutamine drip, betablockers, and digitalis, in addition to vericiguat, and presented with evident clinical improvement. Outcome. A catheterization was recommended to rule out ischemic coronary artery disease as a differential diagnosis, in addition to magnetic resonance or endomyocardial biopsy to rule out other infiltrative pathologies; however, these were not performed due to the patient’s refusal and study limitations. The patient requested voluntary discharge, and medical management was indicated, with continued outpatient study in a clinic.