Double-chambered left ventricle with a thrombus in an asymptomatic patient: A case report

Abstract

BACKGROUND

Double-chambered left ventricle (DCLV) is an extremely rare congenital disease in which the left ventricle (LV) is divided by abnormal muscle tissue. Due to its rarity, there is a lack of data on the disease, including its diagnosis, treatment, and prognosis. Accordingly, we report a case in which DCLV was diagnosed and followed up.

CASE SUMMARY

A 45-year-old man presented to our hospital due to abnormal findings on an electrocardiogram recorded during a health check. He had no specific cardiac symptoms, comorbidities or relevant past medical history. Echocardiography revealed that the LV was divided into two by muscle fibers. There were no findings of ischemia on coronary angiography and coronary computed tomography angiography performed to exclude differential diagnoses. After comprehensive analysis of the images, DCLV was diagnosed. As it seemed to be asymptomatic DCLV, we decided the patient was to be observed without administering any medication. However, follow-up echocardiography revealed a thrombus in the accessory chamber (AC). Anticoagulant medication was initiated, the thrombus resolved, and the patient is currently undergoing follow-up without any specific symptoms.

CONCLUSION

Asymptomatic, uncomplicated DCLV was diagnosed through multimodal imaging; however, a thrombus in the AC occurred during the follow-up. The findings highlight that multimodal imaging is essential in diagnosing DCLV, and that anticoagulation is important in its management.

Keywords: Double-chambered left ventricle; Congenital heart disease; Left ventricular aneurysm; Echocardiography; Coronary computed tomography angiography; Contrast echocardiography; Case report

Core Tip: Double-chambered left ventricle (DCLV) is a rare congenital heart disease. Due to its rarity, the detailed data of the disease are not yet sufficient. We report the progress of a case of DCLV diagnosed incidentally. DCLV was diagnosed using multimodal imaging including echocardiography, coronary angiography, and coronary computed tomography angiography. After one year of follow-up, a thrombus occurred in the accessory chamber. The thrombus resolved after anticoagulation was initiated, and the patient is undergoing follow-up. Through this case, we demonstrate the necessity of multimodal imaging in the diagnosis of DCLV, and the importance of anticoagulation in the management.