Left Ventricular Non-compaction Cardiomyopathy (LVNC) is a rare disorder characterized by abnormal myocardial trabeculations and deep intertrabecular recesses. Diagnostic criteria for LVNC are controversial. Echocardiography remains the primary modality for diagnosis, but there is growing evidence that it may fail in early diagnosis due to its limitation in accurately visualizing the apical and lateral wall trabeculations. This case report describes the use of Cardiac Magnetic Resonance (CMR) imaging to diagnose early LVNC in a young patient where echocardiography had failed. The patient presented with recurrent palpitations and an unremarkable past medical history. The echocardiography results showed only mild hypokinetic changes of the apex, but more than 4,000 ventricular ectopic beats were recorded by Holter monitoring. CMR was performed to exclude myocarditis and cardiomyopathy, and non-compaction ratio measurements met the diagnostic criteria for LVNC. Treatment with a combination of a low-dose ACE inhibitor and a ß-blocker was started and the patient reported almost complete resolution of his symptoms.
[http://dx.doi.org/10.1093/europace/euz046] [PMID: 30882141]