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Congenital heart disease
An abnormal structure of the left ventricle
  1. Yu Kang,
  2. Zheng Li,
  3. Ben He
  1. Department of Cardiology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
  1. Correspondence to Dr Ben He, Department of Cardiology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, 1630 Dongfang Rd, Shanghai, China heben@medmail.com.cn; heben{at}medmail.com.cn

Abstract

CLINICAL INTRODUCTION A 36-year-old man was referred for evaluation of an abnormal left ventricular (LV) structure found incidentally on transthoracic echocardiography (TTE) (figure 1). He had no symptoms except for mild palpitations. There was no significant medical history. Physical examination was unremarkable. ECG showed regular sinus rhythm with ST changes in lead II, III, avF and V6 (see online supplementary file 1). Cardiac magnetic resonance (CMR) (figure 1C) was performed. Treadmill exercise test did not demonstrate any electrocardiographic ischaemic changes. No arrhythmias were noted on Holter monitor. Which of the following is most likely the diagnosis?

Supplementary file 1

Figure 1
Figure 1

Transthoracic echocardiography (TTE) and cardiac magnetic resonance (CMR). (A) Parasternal left ventricular longitudinal axis view of TTE; (B) colour Doppler of parasternal left ventricular longitudinal axis view of TTE; (C) left ventricular longitudinal axis view of CMR.

Questions A: Lateral and inferolateral myocardial infarction

B: Congenital absence of pericardium

C: Pseudoaneurysm

D: Congenital left ventricular outpouching

  • echocardiography

https://doi.org/10.1136/heartjnl-2017-312068

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    Footnotes

    • YK and ZL contributed equally.

    • Funding This work was supported by grants No. 81401411 from the National Nature Science Foundation of China and No. 14ZR1425200 and No. 16ZR1420600 from Nature Science Foundation of Shanghai.

    • Competing interests None declared.

    • Patient consent Obtained.

    • Ethics approval Renji Hospital Research Ethics Committee.

    • Provenance and peer review Not commissioned; internally peer reviewed.