Use of Unique Doppler Flow-Pattern for the Diagnosis of Left Ventricular Diverticulum

Area of Science:

• Cardiology
• Congenital Heart Disease
• Medical Imaging

Background:

• Isolated congenital left ventricular diverticulum (LV) is a rare cardiac anomaly.
• It is often associated with other congenital defects affecting the heart and surrounding structures.
• Diagnosis can be challenging, often requiring advanced imaging techniques to differentiate from other conditions.

Observation:

• A 53-year-old woman presented with an incidental finding of an LV apex outpouching on a non-gated chest CT scan.
• Initial CT findings raised suspicion for a pseudoaneurysm.
• Transesophageal echocardiography (TEE) was crucial for further evaluation.

Findings:

• TEE revealed systolic diminution of the outpouching, characteristic of a muscular left ventricular diverticulum.
• Unique Doppler flow patterns further supported the diagnosis of LV diverticulum.
• The findings successfully differentiated the condition from a post-infarct LV pseudoaneurysm.

Implications:

• This case underscores the importance of comprehensive echocardiographic assessment in diagnosing rare congenital heart anomalies.
• Accurate differentiation between LV diverticulum and pseudoaneurysm is critical for appropriate patient management.
• Conservative management was deemed suitable for this patient, highlighting a potential treatment approach for isolated LV diverticulum.