Left Ventricular Noncompaction with Bicuspid Aortic Valve: A Case Report with a Comprehensive Cardiac MRI Approach

Noncompaction of ventricular myocardium, once thought to represent a rare cardiomyopathy, is being diagnosed with increased frequency. It is often accompanied by various congenital heart diseases. Coexisting valvular anomalies are an emerging issue that requires further investigation in patients with noncompaction cardiomyopathy, because they can increase the potential for adverse clinical events. This article describes the case of a 45-year-old male diagnosed with left ventricular noncompaction (LVNC) with a bicuspid aortic valve. Progressive deterioration of cardiac function in this patient could be explained by myocardial fibrosis and accompanying valvular anomalies on cardiac magnetic resonance imaging (MRI). The clinical implications of cardiac MRI in noncompaction cardiomyopathy are discussed based on its ability to depict both morphological and functional features. Considering the potential for coexisting congenital heart disease to declines in cardiac function, patients with LVNC should be comprehensively evaluated for concurrent cardiac anomalies and myocardial fibrosis.