Conservative management with surveillance over five years showed stable size of left ventricular diverticulum without symptoms or need for intervention in a 51-year-old woman.
Case Report (n=1)
No
Incidental, asymptomatic non-apical cardiac diverticula can be safely managed with conservative surveillance and multimodality imaging without the need for prophylactic intervention.
Cardiac diverticulum is a rare congenital anomaly characterized by an outpouching of a wall segment containing endocardium, myocardium, and pericardium. In contrast to a myocardial scar, there is an absence of fibrotic tissue, and this segment of myocardium contracts synchronously. Despite its rarity, proper recognition is important due to potential complications such as arrhythmia, heart failure, diverticular rupture, cardioembolic disease, and sudden cardiac death. The decision to treat is based on size, symptoms at presentation, and prognosis. Our case involves a 51-year-old woman who was initially diagnosed with cardiac diverticulum in the basal segment of the left-ventricular inferior wall based on a transthoracic echocardiogram. Serial echocardiograms over the subsequent five years showed that the cardiac diverticulum has remained stable. She continues to do well clinically and has remained asymptomatic. The patient has required no cardiac intervention during this time interval.
Tabibiazar et al. (Sun,) conducted a case report in Middle-aged woman (51 years) with incidentally diagnosed non-apical left ventricular cardiac diverticulum, asymptomatic from a cardiac standpoint, no significant comorbidities (n=1). Conservative management with clinical and echocardiographic surveillance was evaluated on Stability of cardiac diverticulum size and absence of cardiac symptoms/events during follow-up. Conservative management with surveillance over five years showed stable size of left ventricular diverticulum without symptoms or need for intervention in a 51-year-old woman.