title: Multiple left ventricular thrombi in a patient with left ventricular noncompaction.
abstract: The major clinical features of myocardial noncompaction are heart failure, arrhythmias, and thromboembolic events. Prominent myocardial trabeculae and deep recesses characteristic of myocardial noncompaction can cause stagnant blood flow and the formation of left ventricular clots. We describe the case of a 62-year-old woman who presented with symptoms of heart failure secondary to left ventricular noncompaction. Transthoracic and transesophageal echocardiography revealed multiple left ventricular thrombi, which had formed despite the patient's long-term therapy with aspirin. Anticoagulative therapy should be considered for patients with myocardial noncompaction who also have risk factors for thromboembolism, such as atrial fibrillation, a history of systemic embolism, or severe left ventricular systolic dysfunction. However, chronic antiplatelet therapy may not sufficiently prevent clot formation in patients who have myocardial noncompaction and severe left ventricular systolic dysfunction.
authors.affiliation: Department of Adult Cardiology, Texas Heart Institute at St. Luke's Episcopal Hospital, Houston, Texas 77030, USA. ccevik@sleh.com
authors.forename: Cihan
authors.initials: C
authors.lastname: Cevik
authors.forename: Nishant
authors.initials: N
authors.lastname: Shah
authors.forename: James M
authors.initials: JM
authors.lastname: Wilson
authors.forename: Raymond F
authors.initials: RF
authors.lastname: Stainback
mesh_terms: D000925:Anticoagulants / Q000627:therapeutic use; D001241:Aspirin / Q000627:therapeutic use; D018618:Echocardiography, Doppler, Color; D017548:Echocardiography, Transesophageal; D005260:Female; D006333:Heart Failure / Q000000981:diagnostic imaging / Q000209:etiology; D006352:Heart Ventricles / Q000000981:diagnostic imaging; D006801:Humans; D056830:Isolated Noncompaction of the Ventricular Myocardium / Q000150:complications* / Q000000981:diagnostic imaging / Q000188:drug therapy; D008875:Middle Aged; D013927:Thrombosis / Q000000981:diagnostic imaging / Q000209:etiology* / Q000517:prevention & control; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging / Q000209:etiology
chemical_list: D000925:Anticoagulants; D001241:Aspirin