Myocardial noncompaction recognized following a transient ischemic attack

Myocardial noncompaction is a rare type of congenital cardiomyopathy characterized by excessively prominent trabeculations in one or more segments of the ventricles and deep intertrabecular recesses in ventricular walls. A 25-year-old male patient presented to the neurology department with complaints of weakness in the left extremities. A mild loss of muscle strength was detected on neurological examination. With a preliminary diagnosis of acute cerebrovascular event, treatment with aspirin and enoxaparin was instituted, which improved his complaints within two hours. Electrocardiography showed sinus rhythm, left ventricular hypertrophy, and loss of R-wave progression in the precordial leads. Transthoracic echocardiography showed apical hypokinesia, marked left ventricular hypertrophy, and normal left ventricular diameters. There were numerous trabeculations in the apex, apical, lateral, and inferior walls, and deep intertrabecular recesses. Color Doppler showed blood flow into the intertrabecular recesses. He also had mild mitral regurgitation and diastolic dysfunction of restrictive type. He was scheduled for outpatient follow-up on aspirin and warfarin treatment.