Two potentially fatal surprises in the preoperative assessment of an asymptomatic young adult.
Isolated left ventricular non-compaction is a rare disease classified as a primary genetic cardiomyopathy and is characterized by heart failure, systemic embolism and ventricular arrhythmias. The diagnosis is established by Doppler echocardiography. We report the case of an asymptomatic young adult, with no history of heart disease, who underwent preoperative assessment for low-risk orthopedic surgery. The electrocardiogram showed left bundle branch block, which prompted further investigation with Doppler echocardiography, cardiac computed tomography angiography and cardiac magnetic resonance imaging. A diagnosis of isolated left ventricular non-compaction and pulmonary embolism was made. Some aspects of preoperative assessment in low-risk surgical patients are discussed.
Universidade Federal Fluminense, Programa de Pós Graduação em Ciências Cardiovasculares, Niterói, Rio de Janeiro, Brasil. Electronic address: lagoeiro@globo.com.
Antonio José
AJ
Lagoeiro Jorge
Universidade Federal Fluminense, Programa de Pós Graduação em Ciências Cardiovasculares, Niterói, Rio de Janeiro, Brasil.
Antonio
A
Alves do Couto
Universidade Federal Fluminense, Programa de Pós Graduação em Ciências Cardiovasculares, Niterói, Rio de Janeiro, Brasil.
Evandro
E
Tinoco Mesquita
Universidade Federal Fluminense, Programa de Pós Graduação em Ciências Cardiovasculares, Niterói, Rio de Janeiro, Brasil.
Mario Luiz
ML
Ribeiro
Universidade Federal Fluminense, Programa de Pós Graduação em Ciências Cardiovasculares, Niterói, Rio de Janeiro, Brasil.
Celso
C
Vale de Souza Junior
Universidade Federal Fluminense, Programa de Pós Graduação em Ciências Cardiovasculares, Niterói, Rio de Janeiro, Brasil.
Wolney
W
de Andrade Martins
D000328:Adult; D001145:Arrhythmias, Cardiac; D004452:Echocardiography; D004562:Electrocardiography; D006352:Heart Ventricles; D006801:Humans; D056830:Isolated Noncompaction of the Ventricular Myocardium / Q000000981:diagnostic imaging*; D055815:Young Adult
Cuidados pré‐operatórios; Embolia pulmonar; Isolated left ventricular non‐compaction; Miocárdio ventricular isolado não compactado; Preoperative care; Pulmonary embolism