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"Cardiac incidentaloma": Left ventricular non-compaction in a kindred with familial coronary artery disease.

Whether to a greater or lesser extent, genetics often plays an important role in the development of cardiovascular diseases. Here we report a newly identified family with familial coronary artery disease (CAD) and left ventricular non-compaction (LVNC). A 52-year-old male with acute coronary syndrome, in whom LVNC had been found "incidentally", was admitted for revascularisation. From a two-dimensional echocardiogram the epicardial layer appeared to be thin and compacted, but the apical endocardial layer of the left ventricle was extremely thickened with prominent trabeculations in the endocardial layer and deep intertrabecular recesses in a channel-like structure. Family history revealed that his 47-year-old brother also had LVNC but to a lesser degree. Their mother had two false tendons in the left ventricular apex and both parents had severe CAD. Left ventricular non-compaction is "incidentally" identified in a kindred with familial CAD. The disease expressivity varies among affected individuals. Whether it is coincidental or there is a genetic link is a question that awaits further investigation. (Cardiol J 2007; 14: 407-410).