[Congenital left ventricular aneurysms and diverticula: clinical findings, diagnosis and course].

UNLABELLED

Congenital aneurysms or diverticula of the left ventricle are rare findings that can be detected by both echocardiography and/or left ventricular angiography. We investigated 16 adult patients presenting either with left ventricular aneurysms (n = 8, mean age 33 +/- 12 years) or diverticula (n = 8, mean age 53 +/- 15 years). In 6 patients the first manifestation of the disease were ventricular arrhythmias, while in the remaining 10 patients the diagnosis was established after echocardiographic examination or cardiac catheterization in search of embolic events, valvular disease or atypical chest pain. In all patients ischaemic heart disease, dilated or hypertrophic cardiomyopathy or arrhythmogenic right ventricular cardiomyopathy could be ruled out. Most of the aneurysms and diverticula were localized below the mitral valve. Patients underwent surgery (n = 1), implantation of cardioverter-defibrillator ICD (n = 2), radiofrequency catheter ablation (n = 1) or drug therapy with class III antiarrhythmics or beta-adrenergic blocking agents (n = 8). Four patients are receiving long-term anticoagulation. With this individually tailored therapy a favourable outcome can be expected in most cases, although during follow-up of 61 (9-121) months one patient died from left heart failure due to amiodarone-induced hyperthyroidism; there were no cerebrovascular complications.

CONCLUSION

Differential diagnosis of symptomatic ventricular tachyarrhythmias or embolic events of unknown origin should include congenital ventricular aneurysms or diverticula.