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Dilated Cardiomyopathy — RACP Paediatrics MCQ

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ModerateCardiologyDilated CardiomyopathyRACP Paediatrics

A 3-year-old presents with tachycardia, tachypnoea, hepatomegaly, and cardiomegaly on CXR. Echocardiogram shows a dilated left ventricle with severely reduced ejection fraction (20%). Coronary arteries are normal. There is no preceding viral illness. What is the most likely diagnosis?

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Correct answer: B — Dilated cardiomyopathy

Dilated cardiomyopathy (DCM) presents with heart failure, cardiomegaly, and reduced ejection fraction without an identifiable acute cause. In children, most cases are idiopathic. Familial/genetic causes (e.g. titin, lamin mutations) account for 30-40%. Management includes ACE inhibitors, beta-blockers, diuretics, and consideration of heart transplantation.

Reference: RCH Melbourne – 2024 – Clinical Practice Guidelines: Cardiomyopathy