A Benign Outpouching Masquerading as a Scar: A Case of an Incidentally Diagnosed Cardiac Diverticulum

Cardiac diverticulum is a rare congenital anomaly characterized by an outpouching of a wall segment containing endocardium, myocardium, and pericardium. In contrast to a myocardial scar, there is an absence of fibrotic tissue, and this segment of myocardium contracts synchronously. Despite its rarity, proper recognition is important due to potential complications such as arrhythmia, heart failure, diverticular rupture, cardioembolic disease, and sudden cardiac death. The decision to treat is based on size, symptoms at presentation, and prognosis. Our case involves a 51-year-old woman who was initially diagnosed with cardiac diverticulum in the basal segment of the left-ventricular inferior wall based on a transthoracic echocardiogram. Serial echocardiograms over the subsequent five years showed that the cardiac diverticulum has remained stable. She continues to do well clinically and has remained asymptomatic. The patient has required no cardiac intervention during this time interval.