How does LV non-compaction on TTE change your secondary stroke prevention management?

Left ventricular non-compaction is a rare condition where the L atrial wall is thick and irregular and can contain areas of clot. I would favor anticoagulation in this situation, rather than antiplatelet therapy, but of course there are no clinical trials regarding this uncommon finding.

It is very patient-dependent. I would make sure I have also evaluated all the other causes of stroke (hypercoagulable states, malignancy, afib, aortic arch, etc.) and also gotten a cardiac MRI to really evaluate any small emboli within trabeculated myocardium. I also take a multidisciplinary approac...