A Novel Case of Acquired Isolated Left Ventricular Non-compaction in a Primigravida: Revisiting the Diagnostic Criteria of Left Ventricular Non-compaction

Left ventricular non-compaction (LVNC) is rare cardiomyopathy characterized by the presence of a two -layered myocardium with prominent trabeculations. It has high rates of mortality and morbidity. Clinical presentation could vary from asymptomatic patients to developing ventricular arrhythmias, thromboembolism, heart failure, and even sudden cardiac death.We present a 23-year-old primigravida with a childhood history of dilated cardiomyopathy secondary to post-viral myocarditis presenting at 32 weeks gestation with dyspnea on exertion. Initial 2-D echocardiogram revealed a mildly dilated left ventricle with apical trabeculation and a 2-layer distinction between compacted and noncompacted myocardium indicating non-compaction of the left ventricle.This case presents a peculiar confluence of cardiac genetics, normal physiology, and infection. We describe a rare form of acquired LVNC that transformed from another type of cardiomyopathy to LVNC during pregnancy drawing attention to the causality pathways of LVNC.

Automated summary

Left ventricular non-compaction (LVNC) is a rare form of cardiomyopathy characterized by two-layered myocardium and high rates of mortality and morbidity. We present a case of acquired LVNC during pregnancy in a patient with a previous history of dilated cardiomyopathy secondary to post-viral myocarditis. This case highlights the unique combination of cardiac genetics, normal physiology, and infection in the development of LVNC.