Left ventricular hypertrabeculation/noncompaction in a patient with peripartum cardiomyopathy

Left ventricular hypertrabeculation/noncompaction (LVHT) is characterized by prominent apical or mid-ventricular lateral and inferior trabeculations that are separated by deep recesses perfused from the left ventricular cavity. Affected myocardium is often thickened with a distinct two-layer appearance of both spongy or noncompacted elements and "normal" or compacted myocardium. This uncommon condition is considered by the World Health Organization to be an unclassified cardiomyopathy. Both congenital and acquired cases have been reported and the condition is genetically heterogeneous. Differing diagnostic criteria for the condition have been proposed. We report a case in which a 25-year-old woman presented with cardiac arrest and dilated cardiomyopathy 8 weeks after delivering her second child. Intraoperative transesophageal echocardiography performed during emergent placement of a left ventricular assist device revealed the typical changes of LVHT in the apex. To our knowledge, this is the first case in which findings consistent with LVHT have been found in a patient with dilated cardiomyopathy in the peripartum period. The patient we present would thus meet existing diagnostic criteria for both LVHT and peripartum cardiomyopathy. (C) 2008 Elsevier Ireland Ltd. All rights reserved.