# A case report of dyspnea that revealed a congenital left cardiac diverticulum of discovery in adulthood with a fatal course

## TL;DR

A rare congenital heart condition was diagnosed in an adult with severe breathing issues, leading to a fatal outcome despite treatment.

## Contribution

This case report highlights the rare presentation and fatal progression of congenital left cardiac diverticulum in adulthood.

## Key findings

- A 61-year-old man presented with dyspnea and was found to have a large left ventricular diverticulum.
- Echocardiography and coronary angiography confirmed the diagnosis but could not prevent a fatal outcome despite surgery.
- The case underscores the importance of early diagnosis and timely intervention for congenital cardiac diverticula.

## Abstract

Congenital cardiac diverticula are rare malformations involving the myocardium, the endocardium, and occasionally the pericardium. They have variable presentations and are often incidental findings.

A 61-year-old man with no significant history presented worsening exertional dyspnea. Examination revealed obesity but was otherwise unremarkable. Initial tests were normal, but chest radiography showed cardiomegaly and ECG indicated diffuse microvoltage. Echocardiography revealed a large left ventricular diverticulum (7 × 8 cm) with a wide neck (4 cm) and severe dysfunction (EF 30 %). Coronary angiography confirmed normal coronary arteries. Despite intensive care, his condition deteriorated and required mechanical ventilation and vasoactive support. He underwent emergency surgery but succumbed intraoperatively.

Although rare, congenital cardiac diverticula can cause severe complications, including heart failure and sudden death. Echocardiography is the key to diagnosis, with CT or MRI providing further characterization. Surgery is the preferred treatment for symptomatic cases, while asymptomatic patients require close follow-up.

This case highlights the need for early diagnosis and timely intervention in congenital cardiac diverticula to prevent fatal outcomes.

•Congenital left cardiac diverticulum is a rare anomaly often discovered incidentally, but in this case, it presented with severe dyspnea and a rapidly deteriorating clinical course in adulthood.•Echocardiography, coronary angiography, and ventriculography played a crucial role in diagnosing the large left ventricular diverticulum, highlighting the importance of multimodal imaging.•Despite intensive medical and surgical intervention, the fatal outcome emphasizes the need for early diagnosis, timely surgical management, and vigilant follow-up in patients with congenital cardiac diverticula.

Congenital left cardiac diverticulum is a rare anomaly often discovered incidentally, but in this case, it presented with severe dyspnea and a rapidly deteriorating clinical course in adulthood.

Echocardiography, coronary angiography, and ventriculography played a crucial role in diagnosing the large left ventricular diverticulum, highlighting the importance of multimodal imaging.

Despite intensive medical and surgical intervention, the fatal outcome emphasizes the need for early diagnosis, timely surgical management, and vigilant follow-up in patients with congenital cardiac diverticula.