Slow infusion of TNK is equally efficacious but more effective than SK in the management of mitral mechanical PVT. 75% to 77.5% of PVT patients completely recovered from TT and it should be the first line therapy where the immediate surgical options were remote.

Left ventricular (LV) diverticulum is defined as a protrusion of the free wall of the ventricle, including endocardium, myocardium, and pericardium. It is classified into fibrous and muscular types. Most of the patients are asymptomatic. It is mainly diagnosed by echocardiography, magnetic resonance imaging, and ventriculography. Surgery is the treatment of choice if the patient is symptomatic associated with other cardiac anomalies. In asymptomatic patient with isolated LV diverticulum, the treatment is controversial. Our patient is a 35-year-old male presented with progressive dyspnea on exertion for the past 1 month. Clinical examination was normal. His electrocardiogram revealed sinus tachycardia. There was no evidence of ischemic changes. Echocardiogram revealed aneurysmal outpouching of the posterolateral basal segment of the left ventricle adjacent to the posterior mitral leaflet [Figure 1]. Ejection fraction was 50% with trivial mitral regurgitation. His coronary angiogram showed normal epicardial coronaries. The patient was treated with furosemide, enalapril, metoprolol, and spironolactone. Then, the patient was referred to the cardiothoracic surgery department for further management.