Acute Cardiac and Neurologic Decompensation in a High School Athlete

A 19-year-old African American man presented to a local emergency room with atrial flutter, dysarthria, and left-sided hemiparesis. He was previously healthy and a successful high school athlete. The patient decompensated and went into cardiac arrest. Two-dimensional echocardiography revealed biventricular dilation, severe systolic dysfunction, and a spongy myocardial appearance. Postmortem examination was diagnostic of biventricular noncompaction. Such a fulminant presentation of isolated ventricular noncompaction in a previously healthy and physically fit individual has not yet been described.