Left ventricular non-compaction (LVNC) is a rare cardiomyopathy that usually affects the left ventricle in which the two-layered myocardium has an abnormally thick sponge-like, trabecular layer and a thinner, compacted myocardial layer. It is characterized by prominent trabeculae, showing continuity between the deep trabecular recesses and the ventricular cavity. It has been classified as a primary cardiomyopathy of genetic origin that usually affects the left ventricle; however, right ventricular and bi-ventricular non-compaction have also been described. It can be associated with neuromuscular disorders, cardiac structural abnormalities, and chromosomal defects. However, this classification is somewhat controversial, as the ratio of increased trabecular tissue to compact myocardial tissue used to diagnose LVNC is also found in up to 20% of individuals without cardiomyopathy. In addition, this increased ratio of trabecular tissue has been found in normal physiologic processes such as pregnancy and athletes, likely due to increased preload. LVNC is most commonly asymptomatic; however, in some instances, it can carry a high risk of thromboembolic phenomena, left ventricular dysfunction, malignant arrhythmia, and sudden cardiac death.
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