Key result
LVNC can present de novo in late adulthood with progressive systolic dysfunction.
Why the study?
Left ventricular noncompaction cardiomyopathy is a rare and often underrecognized condition in older adults, with diagnostic challenges due to overlapping cardiac comorbidities and nonspecific presentations.
Case Report (n=1)
This case demonstrates that left ventricular noncompaction cardiomyopathy should be considered in elderly patients presenting with new-onset systolic heart failure, despite its congenital nature.
May warrant LVNC consideration in elderly cardiomyopathy; extends known diagnostic age but remains hypothesis-generating from one case.
Left ventricular noncompaction is a rare cardiomyopathy, often underrecognized in older adults, characterized by prominent myocardial trabeculations and deep intertrabecular recesses. These structural abnormalities can lead to heart failure, arrhythmias, and thromboembolic events. We report the case of an 85-year-old woman with a history of heart failure with preserved ejection fraction and atrial fibrillation who presented with chest pain and dyspnea. Her electrocardiogram (ECG) revealed new diffuse T-wave inversions. Coronary angiography showed no obstructive disease. Transthoracic echocardiography demonstrated features consistent with left ventricular noncompaction cardiomyopathy (LVNC), including a noncompacted-to-compacted ratio greater than 2:1, along with a reduced left ventricular ejection fraction (LVEF) of 25-30% (normal LVEF >55%). Cardiac MRI was recommended to further characterize the myocardial structure, but the patient declined. She was managed with guideline-directed medical therapy for heart failure and anticoagulation and discharged with a wearable defibrillator. While LVNC is congenital, it may remain undiagnosed until later in life, particularly when symptoms arise due to progressive systolic dysfunction. This case illustrates the delayed diagnosis of a congenital condition rather than a late-onset disease. Greater awareness of LVNC and use of advanced imaging modalities, such as cardiac MRI, are important to improve recognition and management in older adults.
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Alavi et al. (2025) conducted a case report in Left Ventricular Noncompaction Cardiomyopathy (n=1). Left ventricular noncompaction cardiomyopathy was evaluated. An 85-year-old woman was diagnosed with left ventricular noncompaction cardiomyopathy, illustrating that this congenital condition can remain undiagnosed until later in life when symptoms arise due to progressive systolic dysfunction.
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