A Rare Case of Left Ventricular Non-Compaction with Coronary Artery Anomaly Complicated by ST-Elevation Myocardial Infarction and Subcutaneous Defibrillator Implantation

Francesca Romana Prandi, Federica Illuminato, Chiara Galluccio, Marialucia Milite, Massimiliano Macrini, Alessio Di Landro, Gaetano Idone, Marcello Chiocchi, Francesco Paolo Sbordone, Domenico Sergi, Francesco Romeo and Francesco Barillà
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Francesca Romana Prandi: Unit of Cardiology, Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy
Federica Illuminato: Unit of Cardiology, Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy
Chiara Galluccio: Unit of Cardiology, Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy
Marialucia Milite: Unit of Cardiology, Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy
Massimiliano Macrini: Unit of Cardiology, Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy
Alessio Di Landro: Unit of Cardiology, Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy
Gaetano Idone: Unit of Cardiology, Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy
Marcello Chiocchi: Department of Diagnostic Imaging, Molecular Imaging, Interventional Radiology and Radiotherapy, University of Rome Tor Vergata, 00133 Rome, Italy
Francesco Paolo Sbordone: Department of Diagnostic Imaging, Molecular Imaging, Interventional Radiology and Radiotherapy, University of Rome Tor Vergata, 00133 Rome, Italy
Domenico Sergi: Unit of Cardiology, Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy
Francesco Romeo: Unit of Cardiology, Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy
Francesco Barillà: Unit of Cardiology, Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy

IJERPH, 2022, vol. 19, issue 2, 1-10

Abstract: Left ventricular non-compaction (LVNC) is a rare congenital cardiomyopathy caused by arrest of normal endomyocardial embryogenesis and characterized by the persistence of ventricular hypertrabeculation, isolated or associated to other congenital defects. A 33-year-old male, with family history of sudden cardiac death (SCD), presented to our ER with typical chest pain and was diagnosed with anterior STEMI. Coronary angiography showed an anomalous origin of the circumflex artery from the right coronary artery and a critical stenosis on the proximal left anterior descending artery, treated with primary percutaneous coronary intervention. The echocardiogram documented left ventricular severe dysfunction with lateral wall hypertrabeculation, strongly suggestive for non-compaction, confirmed by cardiac MRI. At 3 months follow up, for the persistence of the severely depressed EF (30%) and the family history for SCD, the patient underwent subcutaneous ICD (sICD) implantation for primary prevention. To the best of our knowledge, this is the first case of LVNC associated with anomalous coronary artery origin and STEMI reported in the literature. Arrhythmias are common in LVNC due to endocardial hypoperfusion and fibrosis. sICD overcomes the risks of transvenous ICD, and it is a valuable option when there is no need for pacing therapy for bradycardia, cardiac resynchronization therapy and anti-tachycardia pacing.

Keywords: left ventricular non-compaction; STEMI; coronary artery anomaly; heart failure; subcutaneous implantable converter defibrillator (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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