A clinical case of isolated non-compact left ventricular myocardium in a 29-year-old patient

BACKGROUND: Non-compact left ventricular myocardium is a rare heterogeneous pathology, which in the two-layer structure of the myocardium. There is no generally accepted definition of this form of pathology for both echocardiography and cardiac magnetic resonance imaging. Non-compact left ventricular myocardium can occur at any age and is often asymptomatic. Treatment of non-compact left ventricular myocardium is nonspecific and symptomatic.

DESCRIPTION: This study describes a clinical case of a young patient who was diagnosed with non-compact left ventricular myocardium. The disease debuted in the form of cardiac arrhythmia. Holter monitoring showed frequent ventricular extrasystole and atrioventricular block of the first and second degrees. Moreover, echocardiography revealed a decrease in global contractile function of the left ventricle. The diagnosis was made after magnetic resonance imaging of the heart, which revealed the presence of non-compact myocardium of the anterior, lateral, and inferior walls of the left ventricle in the apical and middle segments. Sustained rhythm disturbances were not induced in electrophysiological research by rapid and programmed stimulation. The patient was prescribed antiarrhythmic therapy, followed by echocardiography Holter monitoring. In the future, the patient needs regular monitoring by a cardiologist.

CONCLUSION: Non-compact left ventricular myocardium should be diagnosed at an early stage, so that life expectancy can be increased owing to timely treatment of heart failure and the use of oral anticoagulants, antiarrhythmic drugs, cardiac resynchronization therapy, cardioverter-defibrillator implantation, and heart transplantation when other treatment options are ineffective.