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'Idiopathic' acute myocardial infarction in a young patient with noncompaction cardiomyopathy

Tolga Sinan Güvenç1, Hatice Betül Erer, Servet Altay

  • 1Department of Cardiology, Kafkas University School of Medicine, Kars, Turkey. TSGuvenc@gmail.com

Cardiology Journal
|July 25, 2012
PubMed

Insights

ST-segment elevation myocardial infarction (STEMI) is rare in patients with isolated left ventricular noncompaction (LVNC). This case suggests coronary thromboembolism due to blood stagnation in the LVNC cavity may cause STEMI, even with normal coronary arteries.

Area of Science:

  • Cardiology
  • Genetics
  • Internal Medicine

Background:

  • Isolated left ventricular noncompaction (LVNC) is a rare genetic cardiomyopathy.
  • Microvascular dysfunction causing cardiac ischemia is common in LVNC patients.
  • ST-segment elevation myocardial infarction (STEMI) is an uncommon complication, typically linked to coronary artery disease.

Observation:

  • A 20-year-old male presented with chest pain and was diagnosed with STEMI.
  • Coronary angiography revealed normal coronary arteries, ruling out obstructive coronary artery disease.
  • Echocardiography and MRI confirmed isolated LVNC.

Findings:

  • Acetylcholine infusion and coronary flow reserve measurements did not indicate vasospasm or microvascular dysfunction.
  • The STEMI was deemed 'idiopathic' due to the absence of a clear cause.
  • Coronary thromboembolism, resulting from blood stagnation within the LVNC cavity, was identified as the most probable mechanism.

Implications:

  • This case highlights a rare presentation of STEMI in a young patient with LVNC.
  • It suggests intracardiac thrombosis and subsequent coronary embolism as a potential cause of myocardial infarction in LVNC.
  • Further research is needed to understand and manage this specific complication of LVNC.

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