INVESTIGATIONS AND TREATMENT
Routine laboratory tests showed an increase in B-type natriuretic
peptide (2208 pg/mL), total bilirubin (1.98 mg/dL), aspartate
aminotransferase (81 U/L), alanine aminotransferase (75 U/L), blood urea
nitrogen (33.1 mg/dL) and creatinine (1.46 mg/dL). Chest radiography
revealed cardiomegaly with pulmonary congestion. Electrocardiography
demonstrated sinus tachycardia (HR: 104
/min).
Transthoracic echocardiography
showed diffuse severe hypokinesis of LVEF 30.8%, an increased left
ventricular end-diastolic diameter of 64.4 mm, and moderate mitral
regurgitation (Figure 1).