Left Ventricular Noncompaction in a Patient of Afro-Caribbean Descent: A Call for Risk Assessment in Immigrants from Tropical Regions

Noncompaction of the left ventricular myocardium (LVNC) is a rare cardiomyopathy believed to be caused by intrauterine arrest of normal embryogenesis of the endocardium and myocardium. Noncompaction is characterized by presence of prominent trabeculae, deep intertrabecular recesses and thickening of the myocardium in two distinct layers: compacted and noncompacted. LVNC may or may not be associated with other congenital cardiac defects. Studies in heart failure patients of Afro-Caribbean (black) origin reveal a high prevalence (up to 30%) of myocardial trabeculations and the potential diagnosis of left ventricular noncompaction. It is unclear whether the myocardial morphology is representative of LVNC or whether it represents an ethnicity related epiphenomenon to increased cardiac preload. With increasing phenomenon of immigration from tropical countries to the United States, it is important to identify potential cardiovascular risks that can be attributed to ethnic background. Clinical presentation of LVNC may vary from an incidental finding on an echocardiogram with no symptoms to symptoms attributable to congestive heart failure, cardiac arrhythmias, and systemic thromboembolic phenomenon. Echocardiography is the initial modality of choice for diagnosis [1-5].