Affiliation:
1. Al-Quds University School of Medicine
2. Department of Pediatric Cardiology, Al-Makassed Islamic Charitable Hospital, Jerusalem, Palestine
Abstract
Introduction:
Congenital left ventricular diverticulum (LVD) is a rare congenital cardiac anomaly and may be complicated by fatal adverse events such as diverticulum rupture. Most LVD cases are asymptomatic and often discovered incidentally. Herein, we describe an unusual and peculiar clinical presentation with felicitous surgical management of ruptured LVD.
Case presentations:
A 10-day-old male infant presented with severe, intractable, and unexplained anemia associated with respiratory distress. Upon admission, the patient was clinically shocked with a hemoglobin level of 6.0 g/dl. As chest imaging showed cardiomegaly, echocardiography was performed and revealed a 9×10 mm diverticulum arising from the posterolateral wall of the left ventricle along with blood and clot collection in the pericardium. The patient underwent an urgent surgical resection of the diverticulum. He was followed up for 2 years without any readmissions or cardiac complaints.
Clinical discussion:
Systemic thromboembolism, heart failure, infarction, and tachyarrhythmias have all been reported as complications of LVD. The most serious complication is diverticulum rupture, which can result in death. As a result, this congenital defect should be discovered early to determine the potential risks and plan appropriate treatment.
Conclusion:
Congenital heart defects such as LVD should be suspected in neonates presenting with unexplained and intractable anemia. To avoid the diagnosis confusion and risk of serious complications in LVD patients, such as spontaneous rupture of the diverticulum, we advocate immediate surgical management of LVD in children.
Publisher
Ovid Technologies (Wolters Kluwer Health)
Reference22 articles.
1. Left ventricular diverticulum: case report and review of the literature;Walton-Shirley;Cathet Cardiovasc Diagn,1992
2. Diverticular and aneurysmal structures of the left ventricle in adults: report of a case within the context of a literature review;Makkuni;Tex Heart Inst J,2010
3. Divertículo ventricular congénito izquierdo aislado en adulto: un hallazgo inusual en infarto de miocardio asociado a cocaína;Pedraza-Jiménez;Cardiovasc Metab Sci,2021
4. Congenital ventricular aneurysm and diverticulum in children;Hamaoka;Pediatr Cardiol,1987
5. Congenital ventricular diverticulum or aneurysm: a difficult diagnosis to make;Halpern;Case Rep Cardiol,2018