Utilization of Ultrasound for Rapid Detection of Alcohol-Induced Dilated Cardiomyopathy in the Emergency Department

Document Type

Conference Proceeding - Restricted Access

Publication Date

5-8-2026

Abstract

Alcohol-induced cardiomyopathy is an acquired form of dilated cardiomyopathy caused by prolonged, heavy alcohol use in the absence of other causes. Echocardiography is required to assess ventricular dysfunction and cardiac remodeling. Point-of-care ultrasound (POCUS) can be employed to rapidly evaluate for ventricular dilatation and guide care in the emergency department (ED). Several studies have demonstrated reduced use of other imaging tests when focused cardiac ultrasound is used in the acute care setting. This guides immediate management and avoidance of therapies that could prove harmful, such as intravenous fluids. This case involves a thirty-year-old male presenting with symptoms of acute heart failure. The use of ultrasound in the ED allowed for rapid identification of left ventricle (LV) dilatation and systolic dysfunction, leading to rapid diagnosis and targeted treatment.

A thirty-year-old, previously healthy male presented to the ED with a two-week history of persistent intermittent fevers, cough, pleuritic chest pain, shortness of breath worsened by supine positioning and exertion. He tested positive for COVID-19 two weeks prior to his ED visit. He was referred to the ED from urgent care where a chest x-ray demonstrated cardiomegaly. Upon arrival the patient was hypertensive and tachycardic. Physical exam revealed regular heart rhythm without murmurs, clear lungs, and no lower extremity edema. A CT angiogram was without obvious aortic dissection or pulmonary embolism but showed notable cardiomegaly and a right lower lobe pneumonia. POCUS revealed a dilated LV with severely reduced ejection fraction (EF). He had mildly elevated Pro BNP, troponin, C Reactive Protein, Erythrocyte Sedimentation Rate, and Procalcitonin. His renal function and white blood cell count were within normal limits.

The case demonstrates the utility of POCUS for rapid identification of acute heart failure and cardiomyopathy in the ED. POCUS is superior to clinical and laboratory data in differentiating patients with preserved EF from reduced EF and is readily available for use by emergency physicians. Bedside ultrasound can be used while awaiting comprehensive echocardiography for definitive diagnosis, allowing for more targeted immediate management and avoidance of therapies that could prove harmful.

Comments

2026 Research Day Corewell Health West, Grand Rapids, MI, May 8, 2026. Abstract 1919

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