Cardiac Diverticulum

Abstract

Left ventricular diverticulum (LVD) is a rare clinical entity which contains endocardium, myocardium, and pericardium with normal contractility. Contrary to LV aneurysm, which has thin and fibrotic LV wall with paradoxical movement compared to normal left ventricle contraction. LVD are two types, that is, congenital or acquired. Congenital is more common than acquired form. Classification according to the location is either apical or nonapical. Apical diverticula usually associated with midline thoracoabdominal defects and other cardiac malformations, but nonapical diverticula were isolated. Nonapical diverticula can arise from the anterior-free wall, the subaortic region, or, rarely, from both ventricles. A diagnosis can be usually done by echocardiography, whereas computed tomography angiography, magnetic resonance imaging, and invasive ventriculography also help. A major problem with LVD is thrombosis, embolism, rupture, ventricular arrhythmias, congestive heart failure, and valvular abnormalities. The management of LVD depends on the clinical condition and associated abnormalities. In most asymptomatic person can be managed conservatively. Treatment for high-risk cases includes surgery, anticoagulants, and treatment of arrhythmias.