Left ventricular non-compaction associated with Wolff-Parkinson-White syndrome: Echo, contrast-echo and cardiovascular magnetic-resonance data

Abstract

A 58-year-old man with a history of dyspnoea was admitted for radiofrequency catheter ablation of an accessory pathway. He was diagnosed with Wolff-Parkinson-White syndrome when he presented a ventricular arrhythmia during atrial fibrillation. Transthoracic echocardiography revealed significant left-ventricular dysfunction with an enlarged left ventricle. We noted numerous and prominent trabeculations predominating in the apical and anterior areas and deep intratrabecular recesses, where colour Doppler revealed blood inflow. The non-compacted/compacted myocardium (NC/C) ratio at the end of systole was greater than 2, leading to a diagnosis of left ventricular noncompaction. The echocardiogram (with SonoVue®) revealed contrast in the recesses and reaching the bottom of the left ventricle (Fig. 1, plate 4). The echocardiograms rule out hypertrophic cardiomyopathy and intraventricular thrombus and detect more non-compacted segments. Three-dimensional echocardiography (Fig. 1, plate 3) was helpful in eliminating other differential diagnoses and for determining the location of the trabeculation: the