Key result
Isolated LV noncompaction is linked to idiopathic STEMI from coronary thromboembolism despite normal coronaries.
Why the study?
STEMI is rare in patients with isolated left ventricular noncompaction and usually attributed to coincidental coronary artery disease, with idiopathic cases lacking clear cause.
Case Report (n=1)
Highlights the rare occurrence of STEMI in a young patient with isolated left ventricular noncompaction despite normal coronary arteries, suggesting thromboembolism as a potential mechanism.
Isolated left ventricular noncompaction (LVNC) is a rare hereditary cardiomyopathy characterized by prominent intraventricular trabeculations separated by deep intertrabecular recessus. While cardiac ischemia due to microvascular dysfunction is common in these patients, ST-segment elevation myocardial infarction (STEMI) is rare and usually seen as a consequence of coincidental coronary artery disease. We report the case of a 20 year-old male patient admitted to our emergency department with a complaint of squeezing chest pain who was subsequently diagnosed with STEMI according to electrocardiographic findings, although an emergent coronary angiogram demonstrated normal coronary arteries. Echocardiography revealed isolated LVNC, and the diagnosis was confirmed via magnetic resonance imaging. Repeat coronary catheterization with acetylcholine infusion and coronary flow reserve measurement failed to demonstrate vasospasm or microvascular dysfunction. As no apparent cause was found, this case was designated 'idiopathic' myocardial infarction. Coronary thromboembolism due to stagnation of blood in the left ventricular cavity remained as the most probable mechanism underlying myocardial infarction.
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Güvenç et al. (2012) conducted a case report in ST-segment elevation myocardial infarction and isolated left ventricular noncompaction (n=1). A 20-year-old male with isolated left ventricular noncompaction presented with an idiopathic STEMI despite normal coronary arteries, likely due to coronary thromboembolism from blood stagnation.
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