At approximately four weeks gestation, the ventricles begin to develop luminal projections known as trabeculations. These spongy collections of trabeculations serve to increase the surface contact of the ventricular lumen and myocytes as myocardial mass increases prior to the development of the coronary arteries. As the coronary circulation develops from the epicardium to the endocardium, the ventricular myocardium undergoes compaction into organized myocyte bundles from the base to the apex of the heart. Compaction is typically greater in the left ventricle than the right, and is the reason trabeculations are considered a normal aspect of the right ventricular morphology and not that of the left ventricle (Sedmera & McQuinn …show more content…
In addition to congestive heart failure, 17% of patients presented with documented or presumed arrhythmias. This is particular concerning given that about 12% of those presenting with arrhythmias presented following aborted sudden death. The most common arrhythmias included ventricular tachycardia, atrial tachycardia, and reentrant supraventricular tachycardia (Brescia et al. 2013). The etiology of the arrhythmogenic myocardium in LVNC is unclear at this time though may be related to the increased dispersion of repolarization seen in more immature, non-compacted myocardium. In addition to congestive heart failure and arrhythmias, adults often present following a thromboembolic event. In these instances, the lack of laminar flow through intertrabecular recesses combined with stasis caused by a hypokinetic left ventricle are the presumed