The Unwanted Soft Spot: A Rare Case of Biventricular Non-compaction Cardiomyopathy Causing Heart Failure in an Adult Filipino Male

Abstract

Biventricular non-compaction cardiomyopathy is a rare genetic cardiomyopathy caused by an early cessation of compaction of trabecular meshwork during embryogenesis. The clinical manifestations range from asymptomatic to severe reduced ventricular dysfunction. We present a rare case of biventricular non-compaction cardiomyopathy in an adult Filipino male presenting with heart failure symptoms. A 61-year-old male presented with a 1-year history of easy fatigability accompanied by bipedal oedema. ECG showed AF in rapid ventricular response. Echocardiography revealed wall motion abnormality with mid-range ejection fraction. Cardiac MRI showed biventricular dilatation with reduced systolic function. He was stable throughout the hospital stay and discharged with guideline-directed heart failure medications. Biventricular non-compaction cardiomyopathy is rare. However, it can be seen as a spectrum of phenotypic manifestations as this may be a form of cardiomyopathies. The management primarily depends on the clinical manifestation, as no specific treatment protocol exists. A correct diagnosis is essential because of the possible associations and the need for long-term management and screening of family members.