The treatment for individuals with LVNC is focused on treating associated types of heart muscle disease such as a thick heart muscle (hypertrophic cardiomyopathy) or poorly squeezing heart muscle. The primary goal is to improve cardiac function and to prevent symptoms. Medications are used to treat symptoms, reverse heart damage and to prevent ongoing damage to the heart muscle. If an individual has decreased heart function, they are at an increased risk for a clot to form in between the trabeculations. A blood thinner, such as aspirin, may be recommended for some individuals to prevent blood clots forming. The formation of a clot places an individual at risk for stroke or other organ damage that can occur if a clot leaves the heart. Individuals with LVNC need to be followed by a cardiologist on a regular basis.
Lifestyle changes are recommended for some individuals. Exercise is generally important, however, individuals with LVNC may experience fatigue and shortness of breath with exercise. It’s important for these individuals to limit their activity if they become tired, dizzy or have difficulty breathing. In some cases, participating in competitive or endurance sports may place an individual at increased risk for heart rhythm problems and may be discouraged.
Some people with LVNC are at increased risk for sudden cardiac arrest. For these individuals, an implantable cardioverter-defibrillator (ICD) may be recommended. In some patients with LVNC, a pacemaker (cardiac resynchronization therapy) may be combined with the ICD. Mechanical pacing from different areas of the heart may improve the heart’s ability to supply blood to the body.
If cardiac function continues to worsen despite medications, a mechanical device may be necessary to help the heart pump and supply blood to the body. The device that would be used for young children would be the Berlin heart device. For older children and adults there are multiple devices that could be surgically placed to provide cardiac support. In some cases, if the condition is severe, a heart transplant may be considered.