RESUMEN
Non-compaction of the left-ventricular myocardium is an extremely rare cardiomyopathy. The most common clinical manifestations are heart failure, ventricular arrhythmia, thromboembolism, and sudden cardiac death. The condition is diagnosed by two-dimensional echocardiography or magnetic resonance imaging. We report a rare case of a 55-year-old man with coexistence of left ventricular non compaction cardiomyopathy, significant coronary artery disease and massive thrombus formation within recesses in left ventricular cavity.
Asunto(s)
Cardiomiopatías/complicaciones , Enfermedad de la Arteria Coronaria/complicaciones , Trombosis/complicaciones , Cardiomiopatías/diagnóstico por imagen , Cardiomiopatías/patología , Enfermedad de la Arteria Coronaria/diagnóstico por imagen , Enfermedad de la Arteria Coronaria/patología , Ecocardiografía , Insuficiencia Cardíaca/complicaciones , Insuficiencia Cardíaca/patología , Ventrículos Cardíacos/diagnóstico por imagen , Ventrículos Cardíacos/patología , Humanos , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Miocardio/patología , Trombosis/diagnóstico por imagen , Trombosis/patologíaRESUMEN
BACKGROUND: Right ventricular infarction (RVI) develops in 30-50% of patients with inferior wall infarction (IWI). The rates of mortality, morbidity, and complications in these patients are greater than in the patients without RVI. We compared the tissue Doppler imaging (TDI) indices between a group of patients with IWI and RVI, with a similar group of patients who had IWI alone to investigate the application of TDI indices in the evaluation and detection of right ventricular function. MATERIAL AND METHODS: We studied 49 patients with first acute IWI in two groups. Group 1 (N=24) were patients with IWI and RVI while group 2 consisted of patients with IWI alone (N=25), based on standard electrocardiogram criteria. The peak systolic (Sm), peak early (Em) and late (Am) diastolic velocities, and Em/Am ratio were obtained from the apical four chamber view, at the lateral side of the tricuspid annulus. We measured trans-tricuspid early (ET) and peak (AT) filling velocity, ET/AT ratio, right ventricular end diastolic diameter (RVEDD), and tricuspid annular plane systolic excursion (TAPSE) by M-mode TDI projected at the long axis of parasternal view. RESULTS: The RVEDD and E/Em ratio were increased, while the TAPSE was significantly decreased in the patients with RVI as compared to those without RVI (4.7± 0.6 vs. 3.1±0.2 cm; p < 0.005, 5.6±2.21 Vs 4.5±1.2; p<0.006 and 1.7±0.4 vs. 2.3±0.5 cm; p <0.0001, respectively). However, the other statistically measured parameters were not significantly different between these groups. CONCLUSION: The measurement of RVEDD, E/Em ratio, and TAPSE, as right ventricular myocardial systolic and diastolic parameters by pulse wave TDI could be used to objectively assess the status of RV condition in patients with first acute IWI.