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Isolated congenital left ventricular diverticulum in adults
D Vaidiyanathan1, D Prabhakar, K Selvam
1Department of Cardiology, Madras Medical College, Chennai. prabhud@vsnl.com
Insights
Congenital left ventricular diverticulum is a rare cardiac anomaly with varied presentations. Early diagnosis requires a high index of suspicion during imaging like chest X-rays and echocardiography.
Area of Science:
- Cardiology
- Congenital Heart Disease
Background:
- Isolated congenital ventricular diverticulum is a rare condition, typically originating from the left ventricle.
- Its clinical presentation is highly variable, making diagnosis challenging.
Observation:
- Three cases of isolated congenital left ventricular diverticula in patients aged 17-30 years are presented.
- Chest X-ray initially suggested a cardiac anomaly, with echocardiography and angiocardiography confirming the diagnosis.
- Diverticula were located at the left ventricular apex (two cases) and base (one case).
Findings:
- Congenital left ventricular diverticulum exhibits diverse clinical presentations.
- Diagnosis relies on a high index of suspicion when interpreting chest X-rays and echocardiograms.
- Key diagnostic features include a contractile accessory chamber with a narrow neck and an electrocardiogram lacking Q waves.
Implications:
- This condition underscores the importance of thorough imaging interpretation in diagnosing rare cardiac anomalies.
- Increased awareness can lead to earlier and more accurate diagnosis of congenital left ventricular diverticulum.
- Understanding the varied presentations aids in clinical decision-making for affected individuals.
Abstract:
Isolated congenital ventricular diverticulum or aneurysm is rare and usually arises from the left ventricle. The presentation of this condition is diverse. We report three cases of isolated congenital left ventricular diverticula. The age range was 17-30 years. Chest X-ray provided the earliest clinical suspicion in these three cases of a cardiac anomaly which was diagnosed by echocardiography and confirmed by angiocardiography. The location of the congenital left ventricular diverticulum was the left ventricular apex in two cases and basal in the other. We conclude that congenital left ventricular diverticulum is a disease of protean presentations. A high index of suspicion is necessary while interpreting chest X-rays and echocardiographs to diagnose congenital left ventricular diverticulum. A contractile accessory chamber of the left ventricle with a narrow neck with or without midline defects and an electrocardiogram without Q waves is consistent with the diagnosis of congenital left ventricular diverticulum.