Author + information
- Isma Rafiq, MBBS⁎ ( and )
- Ian Williams, MA
- ↵⁎Norfolk and Norwich University Hospital, Papworth NHS Trust, Norwich, Norfolk NR4 7UY, United Kingdom
We are grateful for the comments of Dr. Dawson and colleagues on our image publication (1), which we felt represented a novel form of left ventricular noncompaction (LVNC). At the time of acceptance of our image, no other descriptions of this finding had been published.
Their fascinating pediatric case does bear striking similarities, although it is not identical to our adult case. “Saw tooth cardiomyopathy” is itself a novel description that, like ours, is based solely on noninvasive imaging. Unlike the case described by Davlouros et al. (2), in our submission, the patient had an uneventful childhood and this was an incidental finding; the patient had presented with atypical chest pain and a left bundle branch block pattern on the electrocardiogram. With no other known cases, the long-term diagnostic and prognostic implications are yet to be established. We are in agreement that phenotypic differentiation is extremely important with reference to prognostic implication.
We were at pains to point out that our description was at variance with diagnostic criteria for LVNC in terms of some of the anatomical features and distribution, hence its novelty. We agree that dysplasia rather than noncompaction may be a better description, although histological assessment may be required to confirm this. In the absence of a previous description, we sought a consensus view, including that of a national referral center, as to the likely basis, but we would be happy to modify our view as information becomes available.
- American College of Cardiology Foundation