Left Ventricular Noncompaction: A Rare Cause of Heart Failure in a HIV Patient.

Background: Heart failure in patients with human immunodeficiency virus (HIV) is often from dilated cardiomyopathy as a result of HIV itself, drug myotoxicity, secondary infections, or druginduced atherosclerosis. Left ventricular noncompaction (LVNC) is a rare cardiac congenital abnormality which occurs due to early arrest of endomyocardial morphogenesis. Case: A 47- year-old female patient with HIV presented with sudden onset shortness of breath and symptoms of congestive heart failure. Echocardiography showed noncompacted endocardium with reduced left ventricular function. She was subsequently diagnosed with LVNC. Discussion: Multiple etiologies have been implicated in cardiomyopathy among HIV patients. LVNC is a rare cause of left ventricular failure, particularly in this population. Echocardiography plays a pivotal role in the diagnosis. Conclusion: It is often challenging to identify the underlying cause of cardiomyopathy in a patient with HIV. While LVNC is a rare cause of left ventricular failure, typical findings on echocardiography can obviate the need for a more complex evaluative strategy.

Echo Lucent Space Occupying Lesion on Echocardiogram.

Left atrial space occupying lesions pose diagnostic challenge on echocardiography. We report a 79-year-old man with history of pheochromocytoma with left adrenal mass presented with heart failure symptoms after adrenalectomy. Echocardiogram revealed a large echo lucent structure (6.9 x5.9cm) compressing the posterior wall of the left atrium. Further investigation with computer tomography and barium swallow confirmed the diagnosis of hiatal hernia. In this report we explain the differential diagnosis and simple steps to assist the diagnosis of left atrial space occupying lesions noninvasively.