Letter to the Editor

Postpartum Syncope and Noncompaction in Suspected Encephalomyopathy

Authors: Josef Finsterer, MD, PHD, Claudia Stöllberger, MD

Abstract

Left ventricular hypertrabeculation (LVHT), also known as noncompaction, is an increasingly recognized cardiac manifestation of various neuromuscular disorders (NMDs) and other rare genetic disorders.1–3 To our knowledge, detection of LVHT following diagnostic workup after syncope has not been reported.


A 39-year-old, HIV-negative woman experienced syncope 1 hour after delivering a healthy girl while sitting upright on the edge of the bed. The patient was 159 cm tall, weighed 45 kg, and had a previous history of palpitations since childhood, asthma during adolescence, and anemia. Except for a kidney problem in her mother, the family history was noncontributory. The delivery was associated with marked blood loss (hemoglobin 7.8) and arterial hypotension (blood pressure 80/33 mm Hg). Following delivery, the patient lost consciousness and fell over, striking her head, which resulted in a fracture of the left occipital bone. After regaining consciousness, she complained of headache, vertigo, and dizziness, which repeatedly recurred during the following four days.

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References

1. Ichida F, Tsubata S, Bowles KR, et al. Novel gene mutations in patients with left ventricular noncompaction or Barth syndrome. Circulation 2001;103:1256–1263.
 
2. Pignatelli RH, McMahon CJ, Dreyer WJ, et al. Clinical characterization of left ventricular noncompaction in children: a relatively common form of cardiomyopathy. Circulation 2003;108:2672–2678.
 
3. Stöllberger C, Finsterer J. Left ventricular hypertrabeculation/noncompaction. J Am Soc Echocardiogr2004;17:91–100.
 
4. Finsterer J, Stöllberger C, Schubert B. Acquired left ventricular hypertrabeculation/noncompaction in mitochondriopathy. Cardiology 2004;102:228–230.