Multimodality detection of multiple left ventricular diverticula: A case report and brief review of the literature

Abstract

Left ventricular diverticula (LVD) are rare congenital anomalies usually detected incidentally in the adult population. Most commonly, they are found as a single left ventricular diverticulum in association with other congenital abnormalities but multiple LVD are exceedingly rare. We are describing a patient who was found to have multiple LVD on multimodality imaging studies. He had presented with a sudden cardiac arrest attributed to a combination of alcohol intoxication and QT interval prolongation from hypokalemia and antidepressant medications. The patient was managed conservatively and discharged with an implantable loop recorder for detecting any occult arrhythmias.

Isolated muscular ventricular diverticulum assessment using multi‐parameter echocardiographic imaging: Case reports

“…Most of the available epidemiological data come from retrospective studies, indicating that the incidence of LVDi ranges from .02 to .76%. 5 The incidence of LVDi and RVDi on multidetector CT angiography was 3.4% and .6%, respectively. 6 And VDi is thought to be isolated from or associated with midline thoracoabdominal abnormalities as part of Cantrell's syndrome.…”

Accessory Left Ventricle

“…A large, unrepaired VSD should have caused significant hemodynamic abnormalities by the third decade of life, including cyanosis, dyspnea, and several other features, such as Eisenmenger syndrome. The dynamic relationship between systemic and pulmonary vascular resistance in a long-standing, large VSD should have contributed to some, if not most, of the features of advanced cyanotic heart disease ( 1 ). The lack of cyanotic heart failure in this patient led to suspicion about the accuracy of the diagnosis and indicated the necessity for further investigation.…”

“…LV diverticulum or an accessory LV chamber is 1 of the rare congenital anomalies, and it is typically diagnosed incidentally. It can be a solitary diverticulum, or occasionally multiple diverticula can be found ( 1 ). In most cases, patients are asymptomatic, but the most common symptoms are chest pain and palpitation.…”

Incidentaloma cardiaco en tiempos de COVID-19: divertículo ventricular

“…Consiste en una cavidad que comunica con la cámara ventricular a través de un cuello estrecho, de morfología circular y tamaño variable (0.5-9 cm) 2 . Suele presentarse de forma aislada, en el 30% de los casos, mientras que en el 70% restante se asocia con otras anomalías congénitas 3 . Característicamente compromete todas las capas del corazón (miocardio, endocardio y pericardio) y se contrae de manera sincrónica en sístole con la cámara cardiaca correspondiente 3 .…”

“…Suele presentarse de forma aislada, en el 30% de los casos, mientras que en el 70% restante se asocia con otras anomalías congénitas 3 . Característicamente compromete todas las capas del corazón (miocardio, endocardio y pericardio) y se contrae de manera sincrónica en sístole con la cámara cardiaca correspondiente 3 . Si bien se han reportado casos de complicaciones, en general presenta un curso benigno, y en los casos asintomáticos la tendencia es un tratamiento conservador.…”