Contrast echocardiography: contribution to diagnosis of left ventricular non-compaction cardiomyopathy.

Left ventricular non-compaction (LVNC) is a cardiomyopathy considered to be caused by arrest of normal embryogenesis of the endocardium and myocardium. Echocardiography has been the preferred diagnostic procedure; however, the correct diagnosis is often missed or delayed due to the lack of knowledge about this uncommon disease and its similarities to other diseases of the myocardium and endocardium. Here we present two cases: an asymptomatic 39-year-old man who was considered to be suffering from dilated cardiomyopathy (DCM) for four years; and an asymptomatic 19-year-old man who was considered to be suffering from hypertrophic cardiomyopathy. In a recent echocardiography study carried out in our echo lab, we recognized the morphological diagnostic criteria of LVNC. Contrast echocardiography, a low-cost, easy, repeatable, real-time, and non-invasive technique with no ionising radiation, shows a high correlation in the diagnosis of LVNC. In echocardiography, the importance of contrast agents is twofold, as they can be considered essential for a reliable differentiation between the compacted and the non-compacted myocardium, while at the same time they allow accurate measurement of the ratio. Heightened clinical suspicion is necessary for the accurate diagnosis and management of diseases.