Abstract
Prenatal ultrasound screening has allowed for the detection of in utero cardiac abnormalities. Specifically, distinction is possible between ventricular diverticula and aneurysms, which is important because each condition has a different clinical outcome. We report the case of a 35-year-old, gravida 1, para 1 woman, with no significant past medical history, who underwent routine prenatal ultrasound screening at 32 weeks' gestation. A four-chamber ultrasound of the fetal heart combined with M-mode echocardiography showed abnormal dilatation of the right ventricular chamber measuring 2.2 cm × 1.0 cm but with normal contractility. Delivery was performed at full term by cesarean section, and a right ventricular diverticulum was confirmed by postnatal cardiac computed tomography. The baby developed normally with no cardiac sequelae during followup. This case demonstrates the importance of making a correct diagnosis of ventricular diverticula by prenatal ultrasound when abnormal dilatation of the fetal ventricle is identified during routine screening. Because evaluating the wall contractility by M-mode ultrasound leads to evaluating whether it has the myocardium, we conclude that M-mode echocardiography is effective for the purpose of prenatal cardiac diagnosis and can distinguish between ventricular aneurysms and functioning ventricular diverticula.
Highlights
Ventricular diverticula are rare, with an estimated incidence of 0.013% [1]
When an abnormal heart chamber is noted to be continuous with the ventricle by fetal ultrasound screening, the need to distinguish between a ventricular diverticulum and aneurysm is important
We present a case of a right ventricular diverticulum diagnosed prenatally by motion-mode (M-mode) ultrasonography
Summary
Ventricular diverticula are rare, with an estimated incidence of 0.013% [1]. Embryonic developmental disturbance, myocardial infection, and myocardial infarction are thought to be the causative factors [1, 2], and the prognosis is good in isolated cases. Ventricular diverticula are classified as muscular or fibrous [4, 5] The former is composed of three cardiac layers, including the internal membrane, myocardium, and outside membrane. These have normal systolic contraction and a narrow connection to the ventricle and are usually located at the ventricular apex. Fibrous diverticula are composed of fibrous tissue with residual myocardial fibers These may be associated with akinetic or dyskinetic contraction, may have a broad connection to the ventricle, and are usually connected to subvalvular areas as an isolated lesion. When an abnormal heart chamber is noted to be continuous with the ventricle by fetal ultrasound screening, the need to distinguish between a ventricular diverticulum and aneurysm is important. We present a case of a right ventricular diverticulum diagnosed prenatally by motion-mode (M-mode) ultrasonography
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