Isolated left ventricular noncompaction is a rare form of cardiomyopathy 
characterized by prominent left ventricular trabeculations and intertrabecular 
recesses. The typical clinical manifestations are severe systolic and diastolic 
dysfunction, conduction abnormalities, and cardiac embolic events theorized to 
result from thrombus formation within the intertrabecular recesses. 
Evidence-based recommendations for preventing thromboembolic events in isolated 
left ventricular noncompaction have not been established. We report the case of 
a woman who, at 10 years of age, had been diagnosed with hypertrophic 
cardiomyopathy without systolic dysfunction. At age 30, she presented with left 
hemiparesis consequent to a large right-hemispheric ischemic stroke, and she was 
diagnosed with isolated left ventricular noncompaction. In addition to 
discussing the patient's case, we review the medical literature that pertains to 
isolated left ventricular noncompaction.