Cardiomyopathy associated with noncompaction myocardium in a patient with dextrocardia: a case report

BACKGROUND: The coexistence of cardiomyopathy and dextrocardia is of considerable clinical interest due to its rarity and the complexity of its pathogenesis, which may involve common embryogenetic abnormalities. A clinical case analysis was performed in a 45-year-old patient with dextrocardia who was admitted to the cardiology department. Data from physical examination, laboratory testing (complete blood count, biochemical analysis of blood and urine), and instrumental studies (echocardiography, electrocardiography, chest radiography, and cardiac magnetic resonance imaging) were used.

CASE DESCRIPTION: The article highlights current data on the etiology, genetic aspects, and clinical manifestations of the coexistence of cardiomyopathy and dextrocardia. Particular attention is given to mixed etiology, in which the interaction of genetic mutations (over 1,400 identified genes, including those encoding sarcomeric proteins) with exogenous factors (toxins, inflammation, and metabolic disorders) contributes to the complex pathogenesis and clinical course. An example of such a combined disorder is presented in a clinical case involving a rare anatomical anomaly—dextrocardia, in which the heart is located in the right hemithorax. This combination is quite rare in modern clinical practice; therefore, special attention should be given to a comprehensive diagnostic approach that considers genetic, environmental, and comorbid factors, as well as to the importance of an interdisciplinary strategy aimed at improving prognosis and quality of life.

CONCLUSION: The presented case underscores the importance of thorough diagnostics, including advanced imaging modalities (MRI), for identifying specific cardiomyopathy phenotypes such as left ventricular noncompaction (LVNC) in patients with rare anatomical anomalies. A comprehensive, individualized approach enables the successful implementation of standard therapeutic regimens and achievement of favorable outcomes. The need for further genetic testing is emphasized.