Adult case of isolated noncompaction of left ventricular myocardium revealed at hospitalization for tuberculous pleuritis

A 48-year-old man was diagnosed with isolated noncompaction of the left ventricular myocardium. He had been suffering from dyspnea during light exercise since early February 1997, which worsened with time. Eventually, he visited our hospital on February 14. He was admitted urgently because orthopnea was observed and chest radiogram showed massive left pleural effusion. The diagnoses were pulmonary tuberculosis and tuberculous pleuritis. Echocardiography at admission showed generalized hypokinesis of the left ventricle, so we suspected that his condition was complicated by myocarditis. However, virus antibody levels were not elevated, and no obvious findings compatible with myocarditis or cardiomyopathy were obtained by right ventricular myocardial biopsy. Left ventricular contractility remained low and a trabecular mesh structure was seen at the left ventricular apex. Thus, the diagnosis was isolated noncompaction of the left ventricular myocardium. This disorder has been highlighted in pediatric patients, but few adult cases have been reported.