Congenital ventricular aneurysm and diverticulum in children

Abstract

Clinical profiles were analysed of 18 children with congenital ventricular aneurysm (CVA) and diverticulum (CVD) (nine with CVA and nine with CVD). Of 18 children, only six had any symptoms, consisting of chest discomfort, palpitation, or convulsion. Heart murmurs were heard in nine of the 18 children, and a nonspecific systolic ejection murmur in one. A systolic click was heard in only four children. Dyskinesia of an abnormal protrusion of the cardiac silhouette on the chest x-ray film was detected in only three. The ECG revealed abnormal findings in all children. In those with CVA, signs of myocardial damage or left axis deviation (LAD) and left bundle branch block (LBBB) were the main findings. Among those with CVD, multiple premature ventricular contractions (PVCs) were present in four; some signs of myocardial damage were present in three. None of those with CVD had LAD or LBBB. Among the four children with right ventricular diverticulum, multiple PVCs were present in three. The lesions were detected by two-dimensional echocardiography (2DE) before angiography in 13 (72%) of 18 children. The wall kinetics of the lesions, as seen on 2DE, were in agreement with the subsequent angiographic findings.

Aneurismas y divertículos cardíacos congénitos: reporte de una serie pediátrica

“…La ecocardiografía Doppler color permite realizar el diagnóstico, como también detectar presencia de malformaciones asociadas. Las técnicas 3D y Doppler tisular (Q análisis) aportarán información sobre la calidad de la contracción de la fibra miocárdica, ayudando a definir si se trata de aneurismas o divertículos [9][10][11][12][13][14] . Estudios imagenológicos complementarios como RMC y Tomografía computada cardíaca pueden ser útiles en el estudio, pero no son exámenes de rutina en esta patología [12][13][14] .…”

“…anticoagulación oral y antiarrítmicos, junto con seguimiento estricto para la detección precoz de complicaciones 13 . La periodicidad del seguimiento y la duración de la terapia antiplaquetaria o anticoagulante no están definidas.…”

Fetal Right Ventricular Diverticulum with Pericardial Effusion: To Drain or Not To Drain?

“…These two lesions are differentiated histologically by presence or absence of myocardium [1]. The wall of a diverticulum in fact comprises all three histological layers of a normal cardiac wall: endocardium, myocardium and epicardium and, on echocardiography, right ventricular diverticula show a narrow connection to the ventricle and an active contraction during systole [1,7], due to the presence of viable and well-structured myocardiocytes in the wall, whereas right ventricular aneurysms show a wide connection to the ventricle and a paradoxically motion in systole, due to the presence of few disorganized muscle fibers. Occasionally, however ventricular outpouches can have pathologically elements of both [1,8].…”

“…Occasionally, however ventricular outpouches can have pathologically elements of both [1,8]. We can also make a morphologic distinction between apical and non-apical right ventricular outpouchings (RVOs) [6,7].…”

“…Our experience confirmed that, in asymptomatic patients, conservative management may be a reasonable option as the pericardial effusion rounding the diverticulum may progressively disappear not requiring any therapeutic intervention. ventricular diverticula are silent, with a benign clinical course [1,3,7].…”