Acute onset of congestive HF possible expression of a rare form of dilated cardiomyopathy; Fabry disease that is an X-linked lysosomal storage disorder caused by mutations in the a-galactosidase A gene (GLA) that leads to reduced or undetectable a-galactosidase A (AGAL) enzyme levels and progressive accumulation of glycolipids—primarily globotriaosylceramide (Gb3) and its deacylated form, lysoGb3, in cells throughout the body including vascular endothelial and smooth muscle cells and cardiomyocytes. Here, GLA is linked to dilated cardiomyopathy.