Abstract:
Background. Myocardial noncompaction is a rare congenital cardiomyopathy characterized
by an abnormal myocardial structure. It affects the left ventricle or both ventricles. The
condition can range from asymptomatic forms to severe clinical manifestations such as heart
failure, arrhythmias, and thromboembolic events.
Objective(s) of the study: Presentation of a clinical case of ventricular noncompaction
cardiomyopathy incidentally diagnosed in an elderly patient with severe heart failure and
atrial fibrillation.
Materials and methods. A 75-year-old male was admitted to the Cardiology Department
of MCH „Holy Trinity”. Clinical and paraclinical data, patient’s medical history were obtained
from the medical databases. The patient underwent
Investigations: echocardiography, electrocardiography, chest radiography, abdominal
ultrasonography, biochemical and hematological analyses.
Results. The patient presented with dyspnea on minimal exertion, orthopnea, palpitations,
fatigue. Exam: pale-pink skin, moderate peripheral edema, reduced vesicular murmur,
irregular heart sounds, systolic murmur at mitral and tricuspid valves, HR 76 bpm, BP
110/60 mmHg. Labs: PT 57%, INR 1.29. Echocardiography: severely reduced left ventricle
contractility, noncompaction myocardium, EF 25%, grade III mitral and grade IV tricuspid
regurgitation, severe pulmonary hypertension. Chest X-ray showed pleuropneumofibrotic
changes, venous congestion, marked cardiomegaly. Treatment included beta-blockers, ACE
inhibitors, anticoagulants, and diuretics.
Conclusion(s). In the elderly patient, the late diagnosis of noncompaction cardiomyopathy
was associated with advanced heart failure and atrial fibrillation, highlighting the need for
early recognition of this condition, including the importance of thorough imaging evaluation
even at advanced ages.
