Spongious Ischemic Myocardium
Dealing With Morphological Criteria of Noncompaction Cardiomyopathy
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- cardiac catheterization
- coronary artery bypass
- heart failure
- magnetic resonance imaging
A 38-year-old man from the Philippines with no cardiovascular risk factors or family history of heart disease came to our Emergency Department for progressive dyspnea and symptoms compatible with low cardiac output without previous chest pain. ECG showed sinus tachycardia, low voltages in limb leads, and poor R progression in precordial leads (V1–V4) with narrow QRS. A transthoracic echocardiogram was notable for severe left ventricular (LV) dilation and dysfunction. Interestingly, characteristic features of noncompaction cardiomyopathy were found, as well as the presence of an apical thrombus. The patient was admitted to the Intensive Cardiac Care Unit and was treated with inotropes, diuretics, and vasodilator therapy with significant clinical improvement. During hospitalization, a detailed transthoracic echocardiogram (Figure 1A) was performed confirming previously described findings: trabecular meshwork with deep endomyocardial spaces and noncompacted to compacted myocardium ratio >2 in midlateral and apex and probable thrombus in the apex. A cardiac …