Left Ventricular Noncompaction with Multiple Thrombi in Apical Aneurysm

Intern Med. 2020 Feb 1;59(3):377-381. doi: 10.2169/internalmedicine.3489-19. Epub 2019 Oct 24.

Abstract

A 44-year-old man was admitted to our hospital due to heart failure. Transthoracic echocardiography demonstrated global hypokinesis with an ejection fraction of 25%, prominent trabeculation and deep intertrabecular recesses, and apical aneurysm with multiple thrombi (10×13 mm in the inferior wall, 15×8 mm in the anterior wall). Cardiac magnetic resonance imaging showed an increased ratio of noncompacted (NC) to compacted (C) myocardium (NC/C ratio >2.3) and apical aneurysm. Coronary angiography revealed no significant stenosis. He was therefore diagnosed with left ventricular noncompaction complicated by apical aneurysm. Four weeks after starting anticoagulation, the multiple apical thrombi disappeared without clinical signs of embolism.

Keywords: aneurysm; left ventricular noncompaction; thrombus.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Aneurysm / complications*
  • Aneurysm / diagnostic imaging
  • Aneurysm / drug therapy*
  • Aneurysm / physiopathology
  • Anticoagulants / therapeutic use*
  • Coronary Angiography
  • Echocardiography
  • Heart Failure / complications*
  • Heart Failure / diagnostic imaging
  • Heart Failure / drug therapy*
  • Heart Failure / physiopathology
  • Heart Ventricles / diagnostic imaging
  • Heart Ventricles / physiopathology*
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Thrombosis / etiology
  • Thrombosis / physiopathology*
  • Treatment Outcome

Substances

  • Anticoagulants