eng Science and Education Publishing American Journal of Medical Case Reports 2374-216X 2020-05-29 8 9 281 283 10.12691/ajmcr-8-9-7 AJMCR2020897 article Tian Li 1 Leonel Mendoza 1 Wesley Chan 1 Isabel M. McFarlane Isabel.McFarlane@downstate.edu 1 Department of Medicine, State University of New York Downstate Health Science University, Brooklyn, NY 11203 USA Background: Left ventricular non-compaction cardiomyopathy (LVNC) is a rare congenital cardiomyopathy characterized by increased trabeculation in one or more segments of the ventricle. LVNC presented with non-specific symptoms and highly variable clinical presentation ranging from asymptomatic to progressive heart failure and recurrent or life-threatening arrhythmias. Case presentation: 54-year-old Black man with a history of hypertension, diabetes and end-stage renal disease presented with one day palpitations and lightheadedness following a dialysis session. He denied any dyspnea or syncope. On examination, blood pressure was 175/91 mmHg with irregular pulse. No murmur, rubs or gallops were appreciated. Laboratory were unremarkable except increased creatinine and mild anemia with normal thyroid function test. Electrocardiogram (ECG) revealed atrial fibrillation with normal ventricular rate. Transthoracic echocardiogram revealed mildly increased left ventricular (LV) wall thickness with prominent trabeculation and ejection fraction of 55-60 percent, a pseudo-normal LV filling pattern, with concomitant abnormal relaxation and increased filling pressure, suggestive of LVNC. The patient was switched to apixaban. Genetic testing was recommended for family members. Conclusions: LVNC is rare congenital cardiomyopathy with non-specific symptoms and should be considered among the possible diagnosis in patients presenting with arrythmia patients. Echocardiographic and cardiac magnetic resonance imaging can be utilized to establish diagnosis. http://pubs.sciepub.com/ajmcr/8/9/7/ajmcr-8-9-7.pdf Cardiac arrythmia Non-compaction Cardiomyopathy Trabeculation spongiform