Introduction: T he expression of diabetic cardiomyopathy was first introduced by Rubler et al in 1972 and has subsequently been in the attention of clinicians world wide. As the number of patients with type 1 diabetes mellitus has been increasing in the past deca-des, the interest for early diagnosis and management of associated cardiovascular pathology is greater.
Case presentation: We present the case of a young female patient, smoker, known with type 1 diabetes mellitus, since 2000. She was admitted, at our Clinic, for significant pitting edema and impaired functioning. Clinically: normal weight woman (BMI=22 kg/m²) with facial erythrosis, BP=150/100 mmHg, HR=110 bpm, SO₂=99%, rhythmic heart sounds, protosystolic aortic murmur with clear lungs. She denied any alcohol or substance abuse. Blood workup: NTproBNP=400 pg/ mL, high cholesterol and triglycerides, low albumin, a jeun hypoglycemia with elevated HbA1c (11.1%), creatinine clearance=51 mL/min, urine tested positive for protein and RBC casts. Resting EKG: sinus rhythm with diffuse inverted T waves. Transthoracic echocardiography: increased heterogenous left ventricular mass with diastolic dysfunction and preserved global systolic function, mild mitral regurgitation. Abdominal echography revealed only steatosis hepatomegaly.
Conclusions: Diabetic cardiomyopathy is associated with a greater risk for heart failure, independent of coronary artery disease and hypertension, so it is very important to be recognized early and initiate the appropriate treatment. Particularized evidence to date indicates that this type of cardiomyopathy is common but very often underecognized in young patients. Nevertheless, a strategy for primary/secondary prevention and targeted treatment has not been yet established.