A combination of right ventricular hypertrabeculation/noncompaction and atrial septal defect.

The patient was a 39-year-old man admitted with iterative severe chest distress and breathlessness associated with activity without chest complaint for eight years. In past, he was found to have cardiac murmur and was diagnosed congenital ASD at the time of his 25-year-old. Transthoracic two-dimensional echocardiography showed prominent trabeculations of right ventricle (Fig. 1). The right ventricular and atrium was dilated, right ventricular were hypokinetic and right ventricular function was impaired with an right ventricular area changes fraction of 26%. The left ventricular was not markedly dilated and its function was normal with a left ventricular ejection fraction of 63%. Long-term ASD results in right heart volume overload. Neuroendocrine adaptations also occur, with increased sympathetic activity and circulating catecholamines that result in increased contractility and heart rate. Shorter diastolic time due to tachycardia, increased intramyocardial tension from right ventricular dilatation, and increased myocardial oxygen demand, may result in subendocardial ischemia. The present case, therefore, could be regarded as acquired right ventricular HVM/NVM.