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Cardiomyopathy

Left ventricular noncompaction cardiomyopathy (LVNC) is a rare congenital cardiomyopathy which usually presents early in life but may also manifest itself later in life. We present the case of an elderly woman with LVNC which was discovered incidentally during evaluation for a ST-elevation myocardial infarction. A 67-year-old female smoker without prior cardiac history called emergency medical services due to acute onset dyspnea and left chest pressure without radiation. Electrocardiogram demonstrated two mm of ST-elevation in the anterior precordium. She was given aspirin and sublingual nitroglycerin with resolution of chest discomfort and transported directly to the catheterization lab. Left ventricular noncompaction cardiomyopathy is a rare genetic cardiomyopathy resulting from an arrest of normal ventricular maturation during embryogenesis. Patients commonly present with heart failure, arrhythmia, and thromboembolism. Echocardiography and magnetic resonance imaging may aide in diagnosis and management involves treatment and prevention of heart failure. Per guidelines, it is reasonable to consider ICD therapy in patients with LVNC in presence of syncope, non-sustained ventricular tachycardia, family history of sudden cardiac arrest, or LV ejection fraction ≤ 35% (class IIb) for prevention of sudden death. In our patient, LVNC was presumed to be present at birth and was discovered rather serendipitously during evaluation for myocardial infarction. She later admitted to mildly worsening dyspnea over the past year which had previously been attributed solely to tobacco use. In hindsight the symptoms may have been the first manifestation of LVNC. Christopher D. Janish, Left ventricular noncompaction cardiomyopathy incidentally diagnosed during evaluation for STelevation myocardial infarction
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Last date updated on June, 2014

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