‘Honeycomb appearance’ on three-dimensional transthoracic echocardiography as the landmark of left ventricular non-compaction: two case reports

Abstract

IntroductionLeft ventricular non-compaction is a rare congenital heart disease, and is most commonly diagnosed via two-dimensional echocardiography according to echocardiographic criteria. Recently, transthoracic three-dimensional echocardiography has become available in the clinical setting.Case presentationWe present two isolated cases of left ventricular non-compaction from Japan (in an 84-year-old woman and 47-year-old man) that were confirmed by two-dimensional echocardiography, contrast-enhanced two-dimensional echocardiography, three-dimensional echocardiography and cardiac magnetic resonance imaging. In both cases, three-dimensional echocardiography successfully demonstrated the trabecular meshwork of the left ventricle, referred to as a ‘honeycomb appearance’.ConclusionsThree-dimensional echocardiography has the advantage of visualizing an en-face view of the trabecular meshwork, which is not possible with two-dimensional echocardiography. We further emphasize the clinical utility of three-dimensional echocardiography, which is not limited to just the observation of the trabeculations and inter-trabecular recesses, but can also visualize the trabecular meshwork with a ‘honeycomb appearance’.

Sudden Death in a Case of Isolated Left Ventricular Noncompaction

“…Isolated left ventricular noncompaction has to be distinguished from prominent hypertrabeculation with a normal compact layer. 4 Konishi et al 7 have reported a diagnosis made on an 84-year-old woman and 47-year-old man on a 3D echocardiography where "honeycomb appearance" was considered as landmark in diagnosis of LVNC. Prenatal diagnosis of LVNC may be possible in a Barth syndrome (X-linked recessive inheritance), but in others, fetal scan may appear normal and the disease may present later in life.…”