title: An unusual case of ventricular ectopy in a military pilot.
abstract: BACKGROUND
  Congenital left ventricular diverticula are an uncommon cardiac malformation. Although they may be asymptomatic, their presence is important to note as they are associated with systemic embolization of mural thrombus, valvular regurgitation, heart failure, focal ventricular arrhythmias, and sudden death.
  
  
  METHODS
  We describe a case of an asymptomatic pilot with a significant burden of ventricular ectopy. The diagnosis of a large left ventricular diverticulum was made by cardiac CT and confirmed by cardiac magnetic resonance imaging. No specific treatment was warranted; however, regular on-going follow up was required.
  
  
  CONCLUSIONS
  It is important to seek out a structural cause for frequent ventricular ectopy even in the absence of symptoms. Transthoracic echocardiography is not always able to delineate the entire left ventricular cavity and other imaging modalities such as ECG-gated cardiac CT or gated MRI may need to be used in conjunction to permit assessment for the presence of structural heart disease in the whole heart. Aircrew with a high burden of ectopy require regular follow-up for complications such as more malignant dysrhythmias or LV impairment. In some cases, pharmacological or even surgical treatment is warranted, which may have a significant bearing for the future licensing of aircrew.
authors.forename: Robin
authors.initials: R
authors.lastname: Ray
authors.forename: Tushar
authors.initials: T
authors.lastname: Salukhe
authors.forename: Michael
authors.initials: M
authors.lastname: Rubens
authors.forename: Edward
authors.initials: E
authors.lastname: Nicol
mesh_terms: D000337:Aerospace Medicine; D058070:Asymptomatic Diseases; D004240:Diverticulum / Q000150:complications / Q000151:congenital* / Q000175:diagnosis; D004562:Electrocardiography; D006352:Heart Ventricles / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000473:pathology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D008889:Military Personnel; D014057:Tomography, X-Ray Computed; D018879:Ventricular Premature Complexes / Q000151:congenital* / Q000175:diagnosis / Q000209:etiology