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Ventricular Noncompaction With Left Ventricular Thrombus: A Case Report

Anas Alrefaee1, Kyle Wiseman2, Ndausung Udongwo2

  • 1Cardiology, Jersey Shore University Medical Center, Neptune, USA.

Cureus
|July 7, 2022
PubMed

Insights

Noncompaction cardiomyopathy (NCC) is a rare congenital heart condition. This case highlights NCC with left ventricular thrombus, prompting anticoagulation in a patient without atrial fibrillation.

Area of Science:

  • Cardiology
  • Cardiovascular Imaging
  • Thrombosis

Background:

  • Noncompaction cardiomyopathy (NCC) is a rare congenital cardiomyopathy.
  • It is characterized by left ventricular trabeculations visible on echocardiogram and cardiac magnetic resonance imaging (CMRI).
  • NCC is associated with thromboembolism and an increased risk of ventricular thrombus formation.

Observation:

  • A 73-year-old female presented with a suspected cerebrovascular accident (CVA).
  • Diagnostic imaging (echocardiogram and CMRI) revealed NCC with a left ventricular thrombus.
  • The patient was initiated on warfarin for indefinite anticoagulation.

Findings:

  • This case underscores the rarity of noncompaction cardiomyopathy presenting with left ventricular thrombus.
  • It highlights unique clinical questions regarding anticoagulation strategies (initiation, duration, and agent choice) in NCC patients without atrial fibrillation.

Implications:

  • Consider NCC in patients with unexplained cardioembolic events, such as CVA.
  • Prompt management of NCC with left ventricular thrombus should follow available guidelines, including therapeutic anticoagulation.
  • Further research is needed to establish optimal anticoagulation protocols for NCC-associated thrombosis in the absence of atrial fibrillation.

Keywords:
cardiomyopathyleft ventricular noncompaction cardiomyopathyleft ventricular thrombusnoncompaction cardiomyopathynoncompaction syndromeventricular trabeculations

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