Cardiology Research, ISSN 1923-2829 print, 1923-2837 online, Open Access
Article copyright, the authors; Journal compilation copyright, Cardiol Res and Elmer Press Inc
Journal website https://www.cardiologyres.org

Case Report

Volume 6, Number 6, December 2015, pages 352-356

Chest Pain With Apical Diverticulum in the Absence of Coronary Disease: Case Report and Review of the Literature

Figures

Figure 1.
Figure 1. Chest radiograph (a) and ECG (b) on admission without significant abnormalities. Apical 4-chamber TTE view (c) reveals an apical aneurysm.
Figure 2.
Figure 2. Coronary angiogram (a, b) reveals angiographically normal coronary arteries. Left ventriculography (c, d) reveals an apical aneurismal outpouching.
Figure 3.
Figure 3. Apical four-chamber TTE views with Definity contrast demonstrating a large apical diverticulum.

Table

Table 1. Summary of the Characteristics of Fibrous Versus Muscular Diverticula
 
CharacteristicFibrousMuscular
AgeAdultsChildren
RacePredominately African AmericansNo predilection
PrevalenceNot commonMore Frequent
HistopathologyMostly fibrousMostly muscular
Wall motionNon-contractile, paradoxical motionContractile, synchronous motion
Segments affectedLV apical or subvalvularLV apical; rarely RV
Complications reportedAortic or mitral regurgitation; systemic embolism. Rupture. ArrhythmiaRare complications
Associated abnormalitiesNo midline or congenital cardiac defectsFrequent midline and congenital cardiac defects
Angiography findingsNo volume change during cardiac cycleVolume reduction in systole and increase in diastole
MDCT findingsNo volume change during cardiac cycle; fibrous tissue on diverticulum wallSynchronous contraction with LV; myocardial tissue on diverticulum wall
CMR findingsThin, fibrous wall; no volume change during cardiac cycle; no necrosis or fibrous tissue on delayed enhancementThin, contractile wall; no necrosis or fibrous tissue on delayed enhancement images