Clinical Diagnostic Workflow of Nondilated Left Ventricular Cardiomyopathy: A Case-based Review

Dilated cardiomyopathy is defined as left ventricular (LV) or biventricular dysfunction and dilatation not explained by abnormal loading conditions or coronary artery disease. However, the existing definition does not cover a range of disorders that manifest as a spectrum of electrical, structural, and functional myocardial abnormalities that change over time. With the rising use of echocardiographic speckle tracking strain imaging and cardiac magnetic resonance imaging, subtle myocardial structural or functional pathology can be detected very early in the natural history of the myocardial disease. The 2023 European Society of Cardiology guidelines for cardiomyopathy have coined a new terminology “nondilated LV cardiomyopathy (NDLVC)” to help in early risk stratification and better patient surveillance and therapeutic management. This article is a case series of NDLVC with an emphasis on systematic clinical workup for early diagnosis and better management of this pathology.