Noncompaction and endocarditis in suspected mitochondrial disorder

Area of Science:

• Cardiology
• Neurology
• Pathology

Background:

• Left ventricular hypertrabeculation (LVHT), or noncompaction, is a rare cardiac condition.
• Neurological disorders, such as Parkinsonism and cognitive decline, can have complex etiologies.
• The association between LVHT and systemic diseases requires further investigation.

Observation:

• A 75-year-old female with multiple comorbidities including Parkinson syndrome, stroke-like episodes, and diabetes presented with acute heart failure.
• Echocardiography revealed LVHT, valvular vegetations, and severely reduced fractional shortening, raising suspicion for endocarditis.
• The patient experienced renal failure and ventricular fibrillation, succumbing shortly after diagnosis.

Findings:

• Autopsy confirmed both LVHT and endocarditis.
• The patient's constellation of neurological symptoms suggested an underlying mitochondrial disorder.
• This case presents a unique concurrence of LVHT, endocarditis, and complex neurological disease.

Implications:

• This case suggests a potential association between LVHT, endocarditis, and mitochondrial disorders.
• The findings prompt further research into whether LVHT is a predisposing factor for endocarditis.
• Understanding these associations is crucial for diagnosing and managing patients with complex cardiac and neurological conditions.