skip to main content

LV Non-compaction — EECC MCQ

Instant feedback + full explanation. One question, done properly.

ModerateCardiomyopathyLV Non-compactionEECC

A 22-year-old woman with LV non-compaction cardiomyopathy (LVNC) diagnosed on CMR (meeting Petersen criteria) has LVEF 45% and no symptoms. Genetic testing reveals no pathogenic variants. She asks about exercise and anticoagulation. What is the recommended approach?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: B — Risk assessment is individualised; anticoagulation is not routine unless AF, LV thrombus, or systemic embolism occurs; moderate exercise is generally permitted with normal LVEF

LV non-compaction (LVNC) has a heterogeneous phenotype and prognosis. The 2023 ESC Cardiomyopathy Guidelines adopt an individualised approach: (1) Anticoagulation is not routinely recommended unless there is AF, intracardiac thrombus, prior systemic embolism, or severely reduced LVEF (where thrombus risk is higher). (2) Exercise: moderate exercise is generally permitted in asymptomatic patients with preserved LVEF; competitive sport may be restricted if LV dysfunction or arrhythmias are present. (3) ICD: follows standard HF indications (LVEF <35% with symptoms) rather than LVNC-specific criteria. (4) Over-diagnosis of LVNC is a concern; trabeculation meeting imaging criteria may be a normal variant in athletes, Afro-Caribbean individuals, and pregnant women.

Reference: ESC (2023): Guidelines on Cardiomyopathies