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Left ventricular non-compaction

Case contributed by Tim Luijkx
Diagnosis certain

Presentation

Complete left bundle branch block.

Patient Data

Age: 55
Gender: Male

Patient characteristics:
Length 178 cm, weight 63 kg, BSA 1.79 m² (Dubois).

Dimensions:
LV 61 mm, RV 46 mm, septum 11 mm.

LV-functie: EF 41%, SV 100 ml, EDV 243 ml (136 ml/m²), ESV 143 ml (80 ml/m²).
RV functie: EF 60%, SV 103 ml, EDV 170 ml (95 ml/m²), ESV 67 ml (38 ml/m²).

Dilated left ventricle with marked hypertrabeculated apical half, meeting criteria for noncompaction in all four apical segments (noncompact to compact ratio 2.5 apical anterior wall and 3.0 lateral, septal and inferior apical wall). Basally none of the four segments meet these criteria (should be 2.3).

Dyssynchronous movement of interventricular septum, in keeping with left bundle branch block. There is also clear hypokinesia of the apical LV at the areas of noncompacted myocardium.

Normal morphology and contraction of right ventricle without hypertrabeculation. No valvular abnormalities. No late enhancement.

Small atrial septal aneurysm without evident atrial septal defect.

Conclusion:
Dilated left ventricle meeting criteria for noncompaction in 4 of 8 left ventricular segments associated with decreased ejection fraction (41%). No late enhancement.

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