The effect of dilated cardiomyopathy with moyamoya disease in a 31-year-old Chinese man: A case report

Background: Dilated cardiomyopathy (DCM) is a clinically common and refractory disease; however, few cases of dilated cardiomyopathy have been reported in patients with moyamoya diseases treated by combining traditional Chinese Medicine (TCM) and Western medicine, which has a higher risk of rehabilitation. Case Summary: A 31-year-old man was admitted due to paroxysmal chest tightness and shortness of breath. He denied a history of DCM, hypertension, diabetes, pericarditis, smoking, and alcohol consumption. On admission, his transesophageal echocardiography (Fig. 1A) showed the larger heart with poor myocardial systolic function (left ventricular end diastolic diameter [LVEDd] 60 mm, left ventricular ejection fraction [LVEF] 38% [Teich]). On day 14 of admission, heart-related indicators were better than before. Figure 1. (A) Cardiac ultrasound index during hospitalization. (a) Cardiac ultrasound on June 15, 2022: ultrasonic findings of dilated cardiomyopathy (LAED 41 mm LVEDd 60 mm); mitral regurgitation (moderate); tricuspid regurgitation (moderate); pulmonary hypertension (mild to moderate); reduced left ventricular systolic and diastolic function (LVEF 38%, FS 19%); and pericardial effusion (small amount). (B) Cardiac ultrasound on June 20, 2022: myocardial lesions; left heart enlargement (LAED 42 mm, LVED 60 mm); mitral regurgitation (mild to moderate); tricuspid regurgitation (mild); pulmonary hypertension (mild); reduced left ventricular systolic function (LVEF 27%, FS 13%); and pericardial effusion (small amount). FS = fractional shortening, LAED = left atrium end diastolic, LVED = left ventricular end diastolic diameter, LVEF = left ventricular ejection fraction. Conclusion: The present case is the first report demonstrating appearance the dilated cardiomyopathy (DCM) and moyamoya disease simultaneously in a 31-year-old Chinese man, aimed to report the treatment of such patients using a combination of TCM and Western medicine and analyzing the necessity and advantages of using this treatment for patients suffering from DCM and moyamoya disease, so as to improve the level of clinical diagnosis and treatment of such diseases.