A case of congenital left ventricular diverticulum with pulmonary stenosis and its scintigraphic characteristics.
We encountered a 31-year-old female patient with mild valvular pulmonary stenosis who had no abnormality in the electrocardiogram but pulmonary dilatation in the chest radiograph. Two-dimensional echocardiography and magnetic resonance imaging demonstrated two small protrusions at the interventricular septum indicating diverticula. Large perfusion defects were observed at the anterior wall in the thallium-201 myocardial tomograms. Short axial and vertical long axial images by ECG-gated blood pool tomography revealed an out-pouching best seen during diastole and a good contraction during systole in the corresponding areas. These findings suggested the presence of thin but normal myocardium in the anterior wall, i.e. a muscular type of left ventricular diverticulum. The presence of the muscular type of left ventricular diverticulum at the anterior and septal walls was confirmed by contrast left ventriculography. A congenital diverticulum at the anterior and septal walls with pulmonary stenosis is very rare. Furthermore, its scintigraphic images were quite characteristic and useful for its diagnosis.
Matsuda
K
K
Second Department of Internal Medicine, Sapporo Medical College, Japan.
Nakata
T
T
Kunimoto
S
S
Yonekura
S
S
Tsuchihashi
K
K
Shimamoto
K
K
Iimura
O
O
D000328:Adult; D004240:Diverticulum / Q000150:complications / Q000151:congenital / Q000000981:diagnostic imaging*; D004562:Electrocardiography; D005260:Female; D015637:Gated Blood-Pool Imaging; D006331:Heart Diseases / Q000150:complications / Q000000981:diagnostic imaging*; D006801:Humans; D011666:Pulmonary Valve Stenosis / Q000150:complications / Q000000981:diagnostic imaging*