Multiple left ventricular thrombi in a patient with left ventricular noncompaction

The major clinical features of myocardial noncompaction are heart failure, arrhythmias, and thromboembolic events. Prominent myocardial trabeculae and deep recesses characteristic of myocardial noncompaction can cause stagnant blood flow and the formation of left ventricular clots. We describe the c...

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Bibliographic Details
Published in:Texas Heart Institute journal 2012-01, Vol.39 (4), p.550-553
Main Authors: Cevik, Cihan, Shah, Nishant, Wilson, James M, Stainback, Raymond F
Format: Article
Language:English
Subjects:
Anticoagulants - therapeutic use
Aspirin - therapeutic use
Case Reports
Echocardiography, Doppler, Color
Echocardiography, Transesophageal
Female
Heart Failure - diagnostic imaging
Heart Failure - etiology
Heart Ventricles - diagnostic imaging
Humans
Isolated Noncompaction of the Ventricular Myocardium - complications
Isolated Noncompaction of the Ventricular Myocardium - diagnostic imaging
Isolated Noncompaction of the Ventricular Myocardium - drug therapy
Middle Aged
Thrombosis - diagnostic imaging
Thrombosis - etiology
Thrombosis - prevention & control
Ventricular Dysfunction, Left - diagnostic imaging
Ventricular Dysfunction, Left - etiology
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Summary:The major clinical features of myocardial noncompaction are heart failure, arrhythmias, and thromboembolic events. Prominent myocardial trabeculae and deep recesses characteristic of myocardial noncompaction can cause stagnant blood flow and the formation of left ventricular clots. We describe the case of a 62-year-old woman who presented with symptoms of heart failure secondary to left ventricular noncompaction. Transthoracic and transesophageal echocardiography revealed multiple left ventricular thrombi, which had formed despite the patient's long-term therapy with aspirin. Anticoagulative therapy should be considered for patients with myocardial noncompaction who also have risk factors for thromboembolism, such as atrial fibrillation, a history of systemic embolism, or severe left ventricular systolic dysfunction. However, chronic antiplatelet therapy may not sufficiently prevent clot formation in patients who have myocardial noncompaction and severe left ventricular systolic dysfunction.
ISSN:0730-2347
1526-6702