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Thrombolysis of Ischemic Stroke From Noncompaction in Metabolic Myopathy

Background:Ischemic stroke has not been reported together with left ventricular hypertrabeculation/noncompaction (LVHT) and metabolic myopathy. Methods and Results:In a 32-year-old woman with suspected metabolic myopathy, congenital AV-block, pacemaker implantation at the age of 20, and reduced systolic function, LVHT was detected on echocardiography. Shortly afterward, the patient had a left-sided ischemic stroke and underwent systemic thrombolysis with rTPA 3.5 hours after the onset. After the exclusion of potential causes of stroke, cerebral thromboembolism was attributed to LVHT. Oral anticoagulation was initiated and a cardiac resynchronization system was implanted. Conclusions:LVHT patients with systolic dysfunction or atrial fibrillation experiencing an ischemic stroke may benefit from oral anticoagulation.