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Case Reports
Published online: 2019-06-17
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Left ventricular noncompaction (LVNC) with giant left ventricular aneurysm detected by multi detector computed tomography angiography

Santosh Kumar Sinha, Puneet Aggarwal, Lokendra Rekwal, Anupam Singh, Sunil Tripathi, Nishant Kumar Abhishekh, Vinay Krishna
DOI: 10.5603/FC.a2019.0044

open access

Ahead of print
Case Reports
Published online: 2019-06-17

Abstract

Left ventricular noncompaction (LVNC) is a rare form of cardiomyopathy caused by the failure of myocardial compaction during embryogenesis. Clinical features spectrums from are from being totally asymptomatic to systolic dysfunction, heart failure (HF), tachyarrhythmias, and systemic thromboembolism. However, there have been only few reports regarding its coexistence with LV aneurysm. A 34-year-old man with no significant cardiopulmonary history was evaluated for progressive exertional dyspnoea. The chest radiography exhibited cardiomegaly, mild pulmonary congestion and huge calcified shadow at apex. The laboratory data was unremarkable except for elevated brain-type natriuretic peptide. Transrthoracic echocardiography demonstrated global hypokinesia with an ejection fraction of 30%, prominent trabeculation and deep intertrabecular recesses, and calcified aneurysm (12.3x7.8 cm), and increased noncompacted (NC) endomyocardial layer depth compared to the compacted (C) epicardial layer (NC/C= 2.4) which was further confirmed on multi detector computed tomography (MDCT). Based on these findings, he was diagnosed as LVNC complicated with a giant calcified aneurysm. He was discharged with carvedilol, ramipril, and frusemide and referred for surgical restoration/resection of aneurysm. Here, to the best of our knowledge, we report the patient who had LVNC with biggest LV aneurysm.

Abstract

Left ventricular noncompaction (LVNC) is a rare form of cardiomyopathy caused by the failure of myocardial compaction during embryogenesis. Clinical features spectrums from are from being totally asymptomatic to systolic dysfunction, heart failure (HF), tachyarrhythmias, and systemic thromboembolism. However, there have been only few reports regarding its coexistence with LV aneurysm. A 34-year-old man with no significant cardiopulmonary history was evaluated for progressive exertional dyspnoea. The chest radiography exhibited cardiomegaly, mild pulmonary congestion and huge calcified shadow at apex. The laboratory data was unremarkable except for elevated brain-type natriuretic peptide. Transrthoracic echocardiography demonstrated global hypokinesia with an ejection fraction of 30%, prominent trabeculation and deep intertrabecular recesses, and calcified aneurysm (12.3x7.8 cm), and increased noncompacted (NC) endomyocardial layer depth compared to the compacted (C) epicardial layer (NC/C= 2.4) which was further confirmed on multi detector computed tomography (MDCT). Based on these findings, he was diagnosed as LVNC complicated with a giant calcified aneurysm. He was discharged with carvedilol, ramipril, and frusemide and referred for surgical restoration/resection of aneurysm. Here, to the best of our knowledge, we report the patient who had LVNC with biggest LV aneurysm.

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Keywords

Left ventricular noncompaction; Intertrabecular recesses; Left ventricular aneurysm; Multi detector computed tomography

About this article
Title

Left ventricular noncompaction (LVNC) with giant left ventricular aneurysm detected by multi detector computed tomography angiography

Journal

Folia Cardiologica

Issue

Ahead of print

Published online

2019-06-17

DOI

10.5603/FC.a2019.0044

Keywords

Left ventricular noncompaction
Intertrabecular recesses
Left ventricular aneurysm
Multi detector computed tomography

Authors

Santosh Kumar Sinha
Puneet Aggarwal
Lokendra Rekwal
Anupam Singh
Sunil Tripathi
Nishant Kumar Abhishekh
Vinay Krishna

References (9)
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  9. Abidov A, Stewart JR, Cragg DR, et al. Large LV aneurysm and multiple diverticula in a patient with normal coronary arteries: another form of cardiomyopathy? JACC Cardiovasc Imaging. 2010; 3(10): 1081–1082.

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