Subendocardial perfusion deficits due to left ventricular non-compaction cardiomyopathy: a case report and literature review

Left ventricular non-compaction (LVNC)is a rare disease which is characterized by a two-layered myocardium with excessive trabeculation of the left ventricle. It can occur isolated or in association with other disorders, including congenital heart disease and musculoskeletal disorder. We herein report the case of a 61-year-old woman who presented with recurrent shortness of breath and chest discomfort for thirty years. A Doppler echocardiogram revealed global hypokinesis, with an ejection fraction (EF) of 41% and prominent trabeculations within the apical and lateral wall myocardial zones. LVNC were confirmed with cardiac magnetic resonance imaging (MRI), and suggested subendocardial perfusion deficits. A 64-slice multidetector computed tomography (MDCT) coronary angiograph revealed extensive abnormal interstitial markings and no severe atherosclerotic lesions. Single-photon emission computed tomography (SPECT) revealed a significant, almost irreversible degree of hypoperfusion in the inferior wall of the left ventricle, thus indicating that LVNC was associated with subendocardial myocardial necrosis.