Left ventricular noncompaction with a single coronary artery of anomalous origin

Noncompaction of ventricular myocardium (NVM) is a morphogenetic anomaly of ventricular myocardium that leads to the development of cardiomyopathy. It is frequently associated with other congenital cardiac malformations. A 75-year-old woman was admitted with resting dyspnea lasting for several days. Two-dimensional echocardiography demonstrated an enlarged left ventricle with global impairment of systolic function. The myocardial trabeculations, with multiple recesses, were observed at the apex and mid-ventricular segment of the left ventricle. Contrast echocardiography showed filling of the recesses with the contrast agent. Dynamic contrast magnetic resonance imaging also showed distinctive features of NVM corresponding to the echocardiographic findings. In addition, a coronary artery originating from the proximal ascending aorta was observed. Aortogram and coronary angiography confirmed that the coronary artery had an aberrant origin from the ascending aorta and right coronary artery was an anomalous origin from left anterior descending coronary artery. This case suggests that NVM can present with other life threatening cardiovascular anomalies and different imaging studies are helpful for a comprehensive diagnosis.