Left ventricular noncompaction (LVNC) with giant left ventricular aneurysm detected by multi detector computed tomography angiography

Abstract

Left ventricular noncompaction (LVNC) is a rare form of cardiomyopathy caused by the failure of myocardial compaction during embryogenesis. Clinical features spectrums from are from being totally asymptomatic to systolic dysfunction, heart failure (HF), tachyarrhythmias, and systemic thromboembolism. However, there have been only few reports regarding its coexistence with LV aneurysm. A 34-year-old man with no significant cardiopulmonary history was evaluated for progressive exertional dyspnoea. The chest radiography exhibited cardiomegaly, mild pulmonary congestion and huge calcified shadow at apex. The laboratory data was unremarkable except for elevated brain-type natriuretic peptide. Transrthoracic echocardiography demonstrated global hypokinesia with an ejection fraction of 30%, prominent trabeculation and deep intertrabecular recesses, and calcified aneurysm (12.3x7.8 cm), and increased noncompacted (NC) endomyocardial layer depth compared to the compacted (C) epicardial layer (NC/C= 2.4) which was further confirmed on multi detector computed tomography (MDCT). Based on these findings, he was diagnosed as LVNC complicated with a giant calcified aneurysm. He was discharged with carvedilol, ramipril, and frusemide and referred for surgical restoration/resection of aneurysm. Here, to the best of our knowledge, we report the patient who had LVNC with biggest LV aneurysm.