Xu Liqian, Yang Ji, Yang Yunmei
Department of Geriatrics, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
Heart Surg Forum. 2017 Dec 7;20(6):E252-E255. doi: 10.1532/hsf.1608.
Noncompaction of the ventricular myocardium (NVM) is a rare congenital cardiomyopathy that is characterized by multiple prominent trabeculations and deep intertrabecular recesses, and occurs due to arrest of normal embryogenesis of the endocardium and myocardium. It is also referred to as isolated left ventricular noncompaction (LVNC), because lesions are mainly in the left ventricle. The main clinical manifestations are heart failure, arrhythmia, systemic embolism, and sudden death. Systemic embolism is related to the occurrence of atrial arrhythmias or thrombus formation in the left ventricle. Most resulting thromboembolisms are cerebral or in the arteries of the lower limbs, and renal artery embolisms are rare. There are reports of a few previous cases of renal infarction with diagnoses of NVM on echocardiography, but a thrombus from the left ventricle has never been identified as the cause of a renal artery embolism. This paper reports a 53-year-old male who was admitted to our hospital for LVNC and renal infarction. He had a history of atrial fibrillation 3 years previously. We diagnosed LVNC with a thrombus in the left ventricle using echocardiography. The patient was discharged after renal replacement therapy and treatment with an anticoagulant. During the 2 years of follow-up, his condition remained stable.
心室心肌致密化不全(NVM)是一种罕见的先天性心肌病,其特征为多个突出的肌小梁和深陷的小梁间隐窝,是由于心内膜和心肌正常胚胎发育停滞所致。它也被称为孤立性左心室心肌致密化不全(LVNC),因为病变主要位于左心室。主要临床表现为心力衰竭、心律失常、全身栓塞和猝死。全身栓塞与房性心律失常的发生或左心室血栓形成有关。大多数导致的血栓栓塞发生在脑部或下肢动脉,肾动脉栓塞很少见。以前有一些关于超声心动图诊断为NVM的肾梗死病例报告,但从未确定左心室血栓是肾动脉栓塞的原因。本文报告一名53岁男性因LVNC和肾梗死入院。他3年前有房颤病史。我们通过超声心动图诊断为LVNC伴左心室血栓。患者在接受肾脏替代治疗和抗凝治疗后出院。在2年的随访期间,他的病情保持稳定。