A phospholamban mutation is a rare genetic cause of dilated cardiomyopathy (DCM). Our case describes a young service member who presented with advanced heart failure and was found to have a familial DCM from an autosomal dominant phospholamban mutation. He ultimately underwent a successful heart transplant just 23 days after his initial presentation. This case highlights the importance of genetic screening and surveillance for patients with a family history of DCM, and it identifies a gap in medical standards for military accession.
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