Dilated cardiomyopathy (DCM) is a serious condition often leading to acute heart failure (HF), with diverse etiologies including viral myocarditis. This report details a case of reversible DCM in a 34-year-old male who presented with symptoms of acute HF. Diagnostic workup revealed biventricular dilation with severe systolic dysfunction and serology confirming herpes simplex virus infection. The patient was treated with standard HF therapy and colchicine, leading to significant clinical improvement. Despite the positive viral serology, antiviral therapy was not initiated due to the patient's marked recovery, underscoring the controversial role of antivirals in viral myocarditis-associated DCM. At a one-year follow-up, the patient demonstrated substantial recovery of cardiac function. This case highlights the potential for favorable outcomes with comprehensive management, even in the absence of antiviral therapy, and emphasizes the need for individualized treatment strategies in DCM related to viral myocarditis.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11750206PMC
http://dx.doi.org/10.7759/cureus.76174DOI Listing

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