Noncompaction of the left ventricular myocardium diagnosed during ventriculography.

Corresponding Author: Mehmet Ali Elbey, MD; e-mail: [email protected] 565 Dear Editor, The noncompacted myocardium (NCM) is characterised prominent trabeculations and deep intertrabecular recesses due to interruption of the myocardial fiber compacting during embryogenesis. Major clinical features of NCM include heart failure, arrhytmias and thromboembolic events. A 40-year-old man with shortness of breath, fatigue and chest pain presented at our Clinic. His electrocardiogram had sinus bradycardia and inverted T waves in all precordial leads. For this reason, coronary angiography was performed. But, coronary artery was normal. Surprisingly, left ventricular angiography showed the left ventricle with a wide spongy like layer. The characteristic pattern of NCM was observed in contrast ventriculography, left ventricle showed global hypokinesia (Figure 1). After one day, the patient underwent a transthoracic echocardiogram that showed the multiple muscular trabeculations in the left ventricle (Figure 2). The ejection fraction was 37%. There are only a few angiographic images of noncompaction of left ventricle in the literature. Its diagnosis is usually established by echocardiography and less frequently left ventriculography. In our case, wide spongiform sinusoidal tissue was detected in contrast ventriculography during angiography. If we used only the echocardiography in this case, we could not establish the correct diagnosis.