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Dilated left ventricle with multiple outpouchings - a severe congenital ventricular diverticulum or left-dominant

Xin Zhang1, Run-Yu Ye1, Xiao-Ping Chen2

  • 1Department of Cardiology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China.

World Journal of Clinical Cases
|August 11, 2022
PubMed

Insights

Left-dominant arrhythmogenic cardiomyopathy (LDAC) is a rare condition often misdiagnosed. Early detection using advanced imaging is crucial for managing this heart disease and preventing sudden cardiac death.

Area of Science:

  • Cardiology
  • Medical Imaging
  • Electrophysiology

Background:

  • Left-dominant arrhythmogenic cardiomyopathy (LDAC) is a rare, severe heart condition associated with sudden cardiac death and ventricular arrhythmias.
  • LDAC is frequently misdiagnosed due to non-specific early symptoms, often mistaken for myocardial infarction, myocarditis, or dilated cardiomyopathy.

Observation:

  • A 57-year-old woman presented with sinus bradycardia and chronic bifascicular block, experiencing occasional chest pain and palpitations.
  • Diagnostic workup including ECG, echocardiography, CT angiography, and MRI confirmed LDAC, ruling out congenital ventricular diverticulum.

Findings:

  • Comprehensive cardiovascular imaging is vital for accurate diagnosis of LDAC and other cardiomyopathies.
  • The patient received standard heart failure therapy and an implantable cardioverter-defibrillator, leading to stable left ventricular function and symptoms over two years.

Implications:

  • Clinicians should consider LDAC in patients with localized left ventricular abnormalities and multiple ECG changes.
  • Multimodality imaging aids in identifying various cardiomyopathies and assessing cardiac structures, improving diagnostic accuracy.
Abstract

Keywords:
Case reportCongenital ventricular diverticulumLeft-dominant arrhythmogenic cardiomyopathyMagnetic resonance imaging

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