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European Heart Journal Advance Access originally published online on February 9, 2007
European Heart Journal 2007 28(13):1591; doi:10.1093/eurheartj/ehl513
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© The European Society of Cardiology 2007. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

Isolated left ventricular diverticulum in an asymptomatic patient

Bayrak Fatih1, Tahsin Guneysu2, Muzaffer Degertekin1,* and Gokmen Gemici1

1 Department of Cardiology, Yeditepe University Hospital, Devlet yolu Ankara Cad No. 102-104, 34752 Istanbul, Turkey
2 Sonomed, Radiology Department, Istanbul, Turkey

* Corresponding author. Tel: +90 533 241 0799; fax: +90 216 578 4963. E-mail address: muzafferd{at}hotmail.com

A 47-year-old male with intermediate risk of coronary artery disease and atypical chest pain was referred to our hospital for multislice computed tomography (MSCT) coronary angiography. MSCT of the patient revealed apical interruption of myocardium and apical diverticulum (15x11 mm) of the left ventricle (Panels A–F). The ECG of the patient was normal sinus rhythm, and the patient had no history of myocardial infarction.

Congenital diverticulum of the left ventricle is a rare cardiac malformation that frequently includes other congenital defects involving the abdominal wall, sternum, diaphragm, pericardium, and heart. Isolated left ventricular diverticulum is found in 30% of cases and is associated with numerous serious complications, such as cardiac arrhythmias, sudden death, endocarditis, systemic emboli, heart failure, cardiac rupture, and intraventricular obstruction. Surgical resection is the treatment of choice in symptomatic patients, whereas the management of asymptomatic patients often represents a therapeutic dilemma.

Panels A and B. Two-chamber MSCT views of left ventricle during diastole (Panel A) and systole (Panel B) demonstrating apical interruption of myocardium and apical diverticulum (15x11 mm) with nodular calcifications on the thinned wall.

Panels C and D. Post-processed three-dimensional rendered systolic images of left ventricle after extraction of myocardium demonstrating apical diverticulum resembling a tear drop falling from the heart.

Panels E and F. MSCT coronary angiography of the patient demonstrating normal coronary arteries (Panel E, left anterior descending artery; Panel F, proximal sections of coronary arteries).

See online Supplementary material for a colour version of this figure available at European Heart Journal online.

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This Article
Right arrow FREE Full Text (PDF) Freely available
Right arrow Supplementary Data
Right arrow An erratum has been published
Right arrow All Versions of this Article:
28/13/1591    most recent
ehl513v1
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Right arrow Articles by Fatih, B.
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Right arrow Articles by Gemici, G.
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