Myocardial Infarction Revealing Non-Compaction of the Left Ventricle: A Rare Case-Based Discussion

Abstract

Left ventricular non-compaction (LVNC) is a cardiomyopathy due to disturbances in the normal development of the heart muscle leading to the persistence of hypertrabeculation. Its incidence is more common in males. The most common clinical presentations at the time of the first diagnosis are heart failure, thromboembolic events, and various rhythm disorders. We report the case of a 52-year-old man, with a probable unexplored history of cerebrovascular accident, who consulted in the emergency room for acute chest pain constrictive retrosternal. The electrocardiogram showed negative T waves in the lateral and inferior septum. The echocardiography showed a trabeculated aspect of the apex of the left ventricle, inter trabecular recesses taking color on color Doppler. Ultra-sensitive troponins were elevated to 351 ng/l. Coronary angiography was performed returning normally. Myocardial ischemia with healthy coronaries secondary to non-compaction of the LV remains poorly understood and may be secondary to an anomaly of the microcirculation, coronary embolization of a thrombus formed at the level of the ventricular trabeculations. The dreadful complications of the discovery of LVNC must draw the cardiologist's attention to this pathology for better subsequent management.