OP05.09: First trimester diagnosis of cardiac diverticulum: two case reports of ventricular outpouching associated with pericardial effusion

Abstract

The congenital cardiac outpouching is a rare abnormality in the fetus. Outpouching can be a diverticulum or an aneurysm. Diverticulum and aneurysm can be differentiated depending on the location, composition and contractility of the wall. The causative factor is a weakening of the ventricular wall, which can be due to embryogenesis defects, infections or local ischemia due to coronary anomalies. Cardiac diverticulum (CD) is more commonly detected from the second trimester. Very few cases are reported in first trimester. Sonographic presentations range from abnormal four-chamber view, arrhythmia, pericardial effusion to fetal hydrops. Generally, the prognosis of an isolated CD is excellent. We present two cases of isolated, congenital cardiac diverticulum diagnosed in the first trimester. Taking into account the site of origin and contractility of the outpouching we considered it to be a cardiac diverticulum. Left ventricular diverticulum diagnosed at Crown–rump length (CRL) of 45 mm. Right ventricular diverticulum at CRL of 76 mm. One case showed arrhythmia. Both cases were associated with large pericardial effusion. Both the pregnancies were terminated. The first trimester diagnosis of cardiac diverticulum is possible following a thorough cardiac examination. Pericardial effusion aids in the diagnosis of the diverticulum. Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.