Abstract

Background: Acute heart failure in Dilated Cardiomyopathy (DCM) is a rare cardiac disease in the pediatric population. A 15-year-old boy was admitted to the emergency department of Kendal Islamic Hospital, Kendal, Indonesia, on June 26th, 2020, with shortness of breath, tachycardia, and oxygen desaturation.

Case Presentation: The chest X-ray showed significant cardiomegaly with a cardiothoracic ratio of 70% and signs of pulmonary congestion. Transthoracic echocardiography revealed dilation of the left atrium and Left Ventricle (LV), decreased global LV systolic function with reduced left ventricular ejection fraction of 22%. Subsequently, he was diagnosed with acute heart failure in dilated cardiomyopathy and discharged on day six of hospitalization.

Conclusion: Focused initial assessment and time-to-therapy in acute heart failure settings need to be understood by all clinicians, especially emergency care physicians.

Keywords: Acute heart failure, Dilated cardiomyopathy, HFrEF, Pediatric cardiomyopathy, Door-to-diuretic therapy, Water drinking.