Key result
A 61-year-old male with left ventricular non-compaction cardiomyopathy developed an ischemic stroke and new-onset reduced ejection fraction, which improved from 28% to 41% after medical therapy.
Why the study?
In non-compaction cardiomyopathy, new-onset reduced ejection fraction and resulting thromboembolism risk can develop rapidly and may not be detected by routine screening.
Case Report (n=1)
This case demonstrates that patients with left ventricular non-compaction can rapidly develop reduced ejection fraction and subsequent cardioembolic stroke, underscoring the need for vigilance and prompt initiation of anticoagulation and guideline-directed medical therapy.
Highlights stroke risk amid acute EF drop in LV non-compaction; hypothesis-generating, needs prospective validation before practice change.
Left ventricular non-compaction (LVNC) cardiomyopathy is an embryological disorder of endocardial trabeculation and can cause heart failure, arrhythmias, and thromboembolism. Lifelong anticoagulation is indicated in patients with reduced ejection fraction due to high risks of thromboembolism. Reduced ejection fraction can develop in these patients as a consequence of this cardiomyopathy, thereby increasing the risk of intracardiac thrombus formation. This new-onset reduced ejection fraction may develop rapidly, which may not be amenable to detection by routine screening. We present a case of non-compaction cardiomyopathy (NCC) with a previously normal ejection fraction who had an ischemic stroke and was found to have new-onset reduced ejection fraction.
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Singh et al. (2023) conducted a case report in Left ventricular non-compaction (LVNC) cardiomyopathy (n=1). Guideline-directed medical therapy and apixaban was evaluated on Left ventricular ejection fraction. A 61-year-old male with left ventricular non-compaction cardiomyopathy developed an ischemic stroke and new-onset reduced ejection fraction, which improved from 28% to 41% after medical therapy.
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