Long-term prophylaxis with oral anticoagulants seems beneficial in all cases with isolated LVNC and has been especially effective in cases where impaired left ventricular function, thrombi, or atrial fibrillation have been documented.
Prognosis of patients with isolated LVNC is determined by the degree and the progression of heart failure, the presence of thromboembolic events, and arrhythmias which may lead to hospital admission in the majority of the adult patients with isolated LVNC.
This is an unusual report of an adult male with no significant previous medical or family history presenting with recent onset of syncope and found to have septal LVNC.
The diagnosis of LVNC is often made by echocardiography, which is often the first diagnostic method used.
ICD implantation is also indicated for primary prevention in patients with LVNC with a left ventricular ejection fraction <35% and New York Heart Association class II to III heart failure.
Three different approaches to the echocardiographic criteria for diagnosis of LVNC have been proposed.
Since trabeculation is mostly located at the apex, which is often difficult to visualize adequately with echocardiography, the above criteria appear complementary for the diagnosis of LVNC.
Diagnostic efficiency of LVNC has evolved with technological advances in echocardiography.
Management based on the new diagnosis of LVNC included optimization of medical therapy for congestive heart failure, implantation of an ICD, warfarin anticoagulation for prevention of systemic thromboembolism and referral for cardiac transplant.
LVNC does not have an invariably fatal course when diagnosed in the neonatal period.
Jenni et al (5) set criteria to accurately diagnose LVNC by echocardiography using 2-dimensional imaging and low scale color flow Doppler.
There is no specific treatment for LVNC and therapeutic measures are directed at dealing with the patient's symptoms (heart failure, cardiac arrhythmias, thromboembolic events) including consideration for cardiac transplantation.