Cardiologists may be faced with a patient complaining of dyspnea, presenting withascites, without pathological jugular swelling, normal ECG, ECHO with normalejection fraction, but with elevated B-type natriuretic peptide (BNP) - acondition that may be suggestive of CCM.11 Considering it is different from a classic presentationof HF, it is necessary to know this syndrome (CCM) and have a degree of clinicalsuspicion for early identification, to prevent its evolution to relatedcomplications, such as suprarenal insufficiency and hepatorenal syndrome(HRS). The gene discussed is NPPB; the disease is cerebral cavernous malformation.