A Case of Multiple Embolic Strokes Caused by a Congenital Left Ventricle Diverticulum Undetected on Echocardiography

Case Report

Austin Cardio & Cardiovasc Case Rep. 2023; 8(2): 1054.

A Case of Multiple Embolic Strokes Caused by a Congenital Left Ventricle Diverticulum Undetected on Echocardiography

Rovere G¹; Perazzolo A²; Moliterno E²; Giarletta L²; Brancasi A²; Marano R²*

1Department of Diagnostic Imaging, Oncological Radiotherapy and Haematology, Agostino Gemelli University Polyclinic Foundation IRCCS, Rome, Italy

2Department of Radiological and Haematological Sciences; Section of Radiology, Catholic University, Rome, Italy

*Corresponding author: Marano R Agostino Gemelli University Polyclinic Foundation IRCCS, Department of Diagnostic Imaging, Oncological Radiotherapy and Haematology, Rome, Italy. Catholic University, Department of Radiological and Haematological Sciences; Section of Radiology, Rome, Italy. Email: [email protected]

Received: April 26, 2023 Accepted: May 18, 2023 Published: May 25, 2023

Abstract

Congenital Left Ventricular Diverticulum (CLVD) is a rare cardiac malformation caused by a localized protrusion of the left ventricular wall and usually diagnosed with routine echocardiography. CLVD is often associated with other cardiac and noncardiac abnormalities, but it can also occur alone. When echocardiography is non diagnostic, other noninvasive techniques such as cardiac CT (CCT) and Cardiac MR (CMR) can help to rule in/out the diagnosis by providing additional information on myocardial structure, morphology, and kinetics of both ventricles and of the diverticulum itself. We report the case of a patient who arrived in the Emergency Department for an acute cerebrovascular ischemic event with embolic pattern, who underwent non invasive diagnostic tests in order to identify the etiology.

Keywords: Cardiac malformation; Left ventricle wall abnormalities; Left ventricle diverticulum; Stroke; Echocardiography; Cardiac MR (CMR)

Abbreviation: CVLD: Congenital Left Ventricular Diverticulum; CCT: Cardiac CT; CMR: Cardiac Magnetic Resonance; CAD: Coronary Artery Disease; RV: Right Ventricle; LV: Left Ventricle; CLVC: Congenital Left Ventricle Cleft; LVA: Left Ventricle Aneurysm

Case Presentation

A 41-year-old female patient, with a history of recurrent stroke, arrives in the emergency department for the acute onset of hemilate deficiency; therefore, she was admitted to the Stroke Unit for therapy e diagnostic workup (Figure 1).