Description
Patient male, 34 years old.The patient coughed without obvious inducement 1 month ago,without compared with fever, headache, nausea, vomiting, dyspnea, restricted movement. Echocardiography showed dilated cardiomyopathy, EF: 28%; Coronary angiography showed no vascular stenosis. So He was diagnosed with dilated cardiomyopathy in the other hospital.In the last 2 weeks, the condition has deteriorated.He was transferred to our hospital. The admission diagnosis is “dilated cardiomyopathy”.
Key Finding(s)
Physical examination: aortic valve audible and systolic 2/6 grade murmurs and diastolic moderate murmurs, water pulse.Mild concave edema in both lower extremities.TTE: Left ventricular end diastolic diameter is 94mm. TEE: The aortic valve has two leaves, the leaves are thickened, the opening is slightly restricted, the right coronary valve is fused and prolapsed with no coronary valve, the aortic valve is refluxed a lot, and the mitral valve is refluxed mild. CEUS: Simpson EF: 36.7%.
Differential Diagnosis
Bicuspid aortic valve, mild aortic valve stenosis and severe insufficiency; Left ventricular systolic function decreased; minor regurgitation of mitral and tricuspid valves. All were confirmed by cardiac surgery followed. Implication(s)
DCM usually combined with different degrees of functional mitral regurgitation (fMR). If the diameter of left ventricle is huge, severe mitral regurgitation should be performed instead of mild. So for patients with heart failure who have a large left ventricle, we must pay attention to do some examinations to find the real cause, especially exclude congenital valvular disease, before diagnosing DCM.

A case of Misdiagnosis of congenital aortic malformation with giant left ventricle

ECHO ASIA is organized by Asian-Pacific Association of Echocardiography (AAE). The meeting combines the basic echocardiography training curriculum and the state-of-the-art lectures/scientific sessions provided by international as well as Asian-Pacific experts. The meeting is a unique forum where scientists from many countries in the Asian-Pacific region who are involved in the field of Doppler echocardiography gather together to exchange knowledge and skills. Various internationally distinguished faculties consent to present their findings and reveal their clinical experiences in ECHO ASIA.