Left ventricular noncompaction with ventricular aneurysm in a 6-year-old patient

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Дәйексөз келтіру

Толық мәтін

Аннотация

Ventricular noncompaction is a rare type of cardiomyopathy often associated with a ventricular aneurysm. We present a clinical case of a 6-year-old female who arrived at our clinic complaining of physical exertion. Echocardiography revealed prominent trabeculations in the left ventricular wall and a lateral-basal part bulging out, indicating noncompaction of the left ventricular myocardium with an aneurysm. With a noncompacted-to-compacted myocardium ratio of 2.6, magnetic resonance imaging revealed the presence of noncompacted myocardium. It also revealed impaired left ventricular systolic function and a left ventricular aneurysm with myocardial scarring. Coronary angiography ruled out coronary artery disease. Therefore, myocardial scarring was caused by noncompacted myocardium microcirculatory disorder.

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Авторлар туралы

Tairkhan Dautov

«University Medical Center» Corporate Fund

Email: tairkhan.dautov@mail.ru
ORCID iD: 0000-0002-5267-0108
SPIN-код: 8632-6605

MD, Dr. Sci. (Med.), Assistant Professor

Қазақстан, Astana

Bauyrzhan Kaliyev

«University Medical Center» Corporate Fund

Хат алмасуға жауапты Автор.
Email: baur233113@mail.ru
ORCID iD: 0000-0003-4825-749X
SPIN-код: 7315-9129
Қазақстан, Astana

Bibissara Yerekesh

National Research Cardiac Surgery Center

Email: bibisara_97@mail.ru
ORCID iD: 0009-0002-0185-3278
Қазақстан, Astana

Әдебиет тізімі

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  4. Tilahun T, Kedir E, Eshetu B. Fatal Left Ventricular Aneurysm in a 13 Years Old Male Child: A Case Report. Ethiopian journal of health sciences. 2021;31(4):903–906. doi: 10.4314/ejhs.v31i4.26
  5. Tian S, Liang H, Li X, et al. A novel mutation in the TTN gene resulted in left ventricular noncompaction: a case report and literature review. BMC Cardiovascular Disorders. 2023;23(1):352. doi: 10.1186/s12872-023-03382-w
  6. Yakabe D, Matsushima S, Uchino S, et al. Left Ventricular Noncompaction with Multiple Thrombi in Apical Aneurysm. Internal Medicine. 2020;59(3):377–381. doi: 10.2169/internalmedicine.3489-19
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1. JATS XML
Жүктеу
2. Fig. 1. Transthoracic echocardiography (cardiac sensor, two-dimensional scanning) of a 6-year-old patient with myocardial non-compactness and left ventricular aneurysm: a - in the apical four-chamber projection in gray scale mode, bulging of the left ventricular wall and myocardial non-compaction are noted, the ventricle is connected to the aneurysm (asterisk); b — in the apical four-chamber projection in the color Doppler mapping mode, a large anechoic formation is determined (aneurysm is indicated by an asterisk) with pronounced trabeculation in the area of the apex and lateral walls of the left ventricle; c — in a three-chamber projection in the color Doppler mapping mode, the aneurysm (asterisk), inlet and outlet of the left ventricle are determined.

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3. Fig. 2. Magnetic resonance imaging of the heart in a 6-year-old patient with myocardial non-compaction and left ventricular aneurysm. The scanning was carried out on a 1.5-T magnetic resonance imaging scanner (MAGNETOM Avanto, Siemens Healthcare, Germany) with breath holding: a - on a two-chamber image along the short axis before the introduction of a contrast agent, a well-defined protrusion of the lateral wall of the left ventricle (asterisk) and local thinning of the myocardium (arrows). Echo time (Time of echo) - 1.5 ms, repetition time (Repetition time) - 42 ms; b — on a four-chamber image along the long axis before the introduction of a contrast agent, an aneurysm (asterisk) in the basal part of the lateral wall of the left ventricle and non-compact myocardium are determined (the ratio of non-compact and compact layers is 2.6: 1). Echo time - 1.5 ms, repetition time - 42 ms; c - on a four-chamber long-axis image after contrast, there is late gadolinium enhancement (arrows) in the basal region of the anterolateral wall of the left ventricle, where the aneurysm is located (asterisk). Echo time - 1.5 ms, repetition time - 700 ms; d - on a two-chamber short-axis image after contrast, the accumulation of contrast agent in the first, fifth and sixth segments is determined. Echo time - 1.5 ms, repetition time - 2000 ms; e - Two-chamber long-axis image shows late gadolinium enhancement in the basal anterior wall of the left ventricle. Echo time is 1.4 ms, repetition time is 700 ms.

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Метадеректер
4. Fig. 3. Non-compactness of the myocardium with a thin-walled aneurysm of the left ventricle. The aneurysm bulges from the basal portion of the anterior wall of the left ventricle during systole. Arrows show the direction of blood flow. Ao - aorta; LA - left atrium; LV - left ventricle; NCM—non-compact left ventricular myocardium; RA - right atrium; RV - right ventricle; aneurism - aneurysm.

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Метадеректер
5. Fig. 4. Coronary angiography of a 6-year-old patient with myocardial non-compaction and left ventricular aneurysm. The study was performed using a 4 Fr sheath and two 5 Fr catheters. a, b - no changes were detected in the coronary arteries; the left type of coronary blood supply is determined. RCA—right coronary artery; LAD—left anterior descending artery; Cx - circumflex artery; D1 - diagonal artery; RV branch - branch of the right coronary artery; AI is an intermediate branch.

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