North Texas Research Forum 2025
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Division
North Texas
Hospital
Medical City Fort Worth
Specialty
Family Medicine
Document Type
Poster
Publication Date
2025
Keywords
heart failure, infiltrative cardiomyopathy
Disciplines
Cardiovascular Diseases | Family Medicine | Medicine and Health Sciences
Abstract
Currently, 2.6% of Americans suffer from heart failure. Common causes include coronary artery disease, chronic hypertension, arrhythmia, and myocardial infarction, often managed in clinical and hospital settings. A rare cause, however, is infiltrative cardiomyopathy, affecting just 0.04% of the U.S. population. This condition, often caused by amyloid buildup or sarcoidosis, is challenging to diagnose and typically requires a heart transplant due to its rapid progression. Thorough investigations into heart failure causes are crucial to identify this rare condition. A 39-year-old male with no significant medical history presented to the University of North Texas Health Science Center (UNTHSC) Family Medicine clinic with exertional shortness of breath, starting two weeks earlier. An electrocardiogram revealed a new onset left bundle branch block, and he was promptly sent to Medical City Fort Worth Emergency Department. Further tests indicated concerns for decompensated heart failure, and he was admitted for inpatient care. The patient reported no significant medical history, medications, or lifestyle factors. Vital signs included a blood pressure of 131/94 and a pulse of 102. The physical exam showed jugular venous distention, tachycardia, and abdominal distension. Initial lab tests, including complete blood count, thyroid function, basic metabolic panel, troponin, and lipid profile, were unremarkable. However, B-type natriuretic peptide (BNP) was elevated at 1300, and chest X-ray showed cardiomegaly and pulmonary vascular congestion. Diagnosed with respiratory failure due to acute heart failure, the patient was started on furosemide. A trans thoracic echocardiogram revealed an ejection fraction of 15-20% with severe left ventricular hypokinesis and mild mitral valve regurgitation. Right heart catheterization showed no significant arterial stenosis. The cardiology and heart failure team who were involved from admission suspected infiltrative cardiomyopathy, started him on prednisone and scheduled a cardiac MRI for a definitive diagnosis. His symptoms improved after diuresis, and he was discharged on day five after placement of a life vest. He has kept all follow-up appointments, and the MRI results are pending. This case highlights the importance of recognizing heart failure symptoms, conducting a thorough workup, and involving specialists early. It is particularly noteworthy due to the patient's lack of significant medical history and the rare nature of infiltrative cardiomyopathy. The case also emphasizes evidence-based treatments and interdisciplinary collaboration to manage complex cases.
Original Publisher
HCA Healthcare Graduate Medical Education
Recommended Citation
Rashik, Mohammed; Adeleye, Olufunmilola; Thompson, Jason; and Mir, Tasaduq, "Shortness of Breath in a 39 Year Old: A Rare Case of Heart Failure" (2025). North Texas Research Forum 2025. 38.
https://scholarlycommons.hcahealthcare.com/northtexas2025/38