The Heart Of It All: Dilated Cardiomyopathy As The Initial Presentation Of Antiphospholipid Syndrome

This case report discusses a 47-year-old woman who presented with dilated cardiomyopathy (DCM) as the initial manifestation of primary antiphospholipid syndrome (APS). Despite having no prior health issues, she experienced acute dyspnea and other symptoms, leading to a diagnosis of APS after testing positive for specific antibodies. The report highlights that DCM in APS is likely due to microvascular thrombotic insults, with up to 20% of APS patients potentially having subclinical diastolic dysfunction. The case underscores the importance of screening for APS in middle-aged women with DCM and suggests that cardiac MRI can be a reliable diagnostic tool. Treatment with warfarin, corticosteroids, and mycophenolate mofetil led to the patient's improvement.