title: Noncompaction and embolic myocardial infarction: the importance of oral anticoagulation.
abstract: Left ventricular noncompaction (LVNC) is characterized by left ventricular (LV) hypertrabeculations and is associated with heart failure, arrhythmias and embolism. We report the case of a 67-year-old LVNC patient, under oral anticoagulation (OAC) therapy for apical thrombosis. After she discontinued OAC, the thrombus involved almost the whole of the left ventricle; in a few months her condition worsened, requiring hospitalization, and despite heparin infusion she experienced myocardial infarction (MI), caused by embolic occlusion of the left anterior descending artery. Although infrequent as a complication of LVNC, and usually attributable to microvascular dysfunction, in this case MI seems due to coronary thromboembolism from dislodged thrombotic material in the left ventricle.
authors.affiliation: Cardiology 1/CCU, S. Camillo Hospital, Rome, Italy. Electronic address: gipulig@yahoo.it.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Pulignano
authors.affiliation: Cardiology 1/CCU, S. Camillo Hospital, Rome, Italy.
authors.forename: Maria Denitza
authors.initials: MD
authors.lastname: Tinti
authors.affiliation: Cardiology 1/CCU, S. Camillo Hospital, Rome, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Tolone
authors.affiliation: Interventional Cardiology, S. Camillo Hospital, Rome, Italy.
authors.forename: Carmine
authors.initials: C
authors.lastname: Musto
authors.affiliation: Cardiology 1/CCU, S. Camillo Hospital, Rome, Italy.
authors.forename: Lucia
authors.initials: L
authors.lastname: De Lio
authors.affiliation: Cardiology 1/CCU, S. Camillo Hospital, Rome, Italy.
authors.forename: Paolo Giuseppe
authors.initials: PG
authors.lastname: Pino
authors.affiliation: Cardiology 1/CCU, S. Camillo Hospital, Rome, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Minardi
authors.affiliation: Interventional Cardiology, S. Camillo Hospital, Rome, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Violini
authors.affiliation: Cardiology 1/CCU, S. Camillo Hospital, Rome, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Uguccioni
mesh_terms: D000284:Administration, Oral; D000368:Aged; D000925:Anticoagulants / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D056830:Isolated Noncompaction of the Ventricular Myocardium / Q000150:complications*; D009203:Myocardial Infarction / Q000209:etiology* / Q000517:prevention & control; D013923:Thromboembolism / Q000150:complications* / Q000517:prevention & control
chemical_list: D000925:Anticoagulants
keywords: Embolia; Embolism; Enfarte do miocárdio; Heart failure; Insuficiência cardíaca; Left ventricular noncompaction; Myocardial infarction; Não compactação ventricular esquerda