Non-compaction on echocardiography and autopsy

In an 80-year old woman with chronic heart failure due to cardiomyopathy, left ventricular non-compaction, also termed left ventricular hypertrabeculation, in the apex, the lateral wall, the posterior wall and proximally to the papillary muscles was diagnosed on echocardiography, two days before decease. Autopsy three days after echocardiography revealed thin and thick, red and white threads closely interwoven to an irregular meshwork. Echocardiography correctly localised non-compaction, but did not detect the fine meshwork and could not differentiate between the compacted and non-compacted layer of the myocardium. Cardiomyopathy was attributed to cardiac involvement in metabolic myopathy, retrospectively diagnosed upon the clinical presentation, recurrent creatine-kinase elevation, lactacidosis, and the presence of non-compaction, frequently associated with neuromuscular disorders.