Clinical and echocardiographic features of left ventricular diverticulum in adults: a report of 4 cases

To explore the clinical and imaging profiles of left ventricular(LV) diverticulum in adults and review the key points for its differential diagnosis. The clinical and imaging features were reviewed for 2 female and 2 male patients clinically diagnosed with LV diverticulum. Their clinical manifestations and electrocardio graphic presentations were nonspecific. On echocardiography, all diverticula, located at LV apex, had a thinned and weakened wall continuing and contracting synchronously with the adjacent LV wall. Two cases were diagnosed as congenital diverticulum without any other cardiac or thoraco-abdominal anomaly. And the other two had existing coronary artery diseases with significantly reduced global and apical LV systolic function. Mural thrombosis in diverticulum was determined in one congenital case. One patient died of cardiac failue. It suggested that LV diverticulum in adults may be congenital and secondary etiologically. The former is mostly isolated and apically situated while the latter often results from regional myocardial ischemia and elevated intracavitary LV pressure at an ill-perfused area. Echocardiography can demonstrate the 2-dimensional and flow hemodynamics of diverticulum in real time so as to facilitate its diagnosis and differential diagnosis. Key words: Diverticulum; Heart ventricle; Echocardiography, Doppler, color