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. 2014 Jan 15;9(4):138-142.
doi: 10.1016/j.jccase.2013.12.006. eCollection 2014 Apr.

Significance of left ventricular clefts-A case report

Andreas Seraphim  1 , Alexandros Papachristidis  1 , Naomi Bratt  1 , Man Fai Shiu  1
Affiliations

Significance of left ventricular clefts-A case report

Andreas Seraphim et al. J Cardiol Cases. .

Abstract

We describe the case of a 48-year-old patient who presented with an out-of-hospital cardiac arrest due to an acute ST-elevation myocardial infarction. Left ventriculography performed during the initial coronary angiography revealed the presence of structural abnormalities in the myocardial wall which subsequently, with the use of contrast echocardiography and cardiac magnetic resonance imaging, were confirmed to represent ventricular clefts. We reviewed the pathophysiological significance of these defects and compared them with similarly looking abnormalities such as aneurysms, pseudoaneurysms, and diverticula. In conclusion, recognition of ventricular clefts is needed to allow clinicians to differentiate them from other myocardial wall defects with different pathological profile and clinical significance. <Learning objective: With emerging techniques in cardiac imaging some cardiac abnormalities such as left ventricular (LV) clefts are recognized more frequently. This case report describes an incidental finding of LV cleft and provides an extensive review of the literature regarding the clinical significance and differential from other similar findings of different pathology. That will help physicians to distinguish these overlapping findings and tailor patients' management accordingly.>.

Keywords: Cleft; Crypts; Fissure; Inferoseptal; Ventricular.

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Figures

Fig. 1
Fig. 1
Upper: left ventriculography (RAO view) showing a pair of LV clefts (white arrows) at basal inferior wall in diastole. Lower: nearly complete obliteration of LV clefts (white arrows) during systole in left ventriculography (RAO view). LV, left ventricular; RAO, right anterior oblique.
Fig. 2
Fig. 2
Transthoracic echocardiogram. Upper left: slightly angulated apical 2-chamber view. LV cleft (white arrow) in basal inferior wall in diastole. Upper right: 2-chamber view (slightly angulated). Obliteration of LV cleft (white arrow) in systole. Lower left: more prominent demonstration of LV clefts (white arrows) with contrast echocardiography in diastole (slightly rotated and angulated apical 2-chamber view). LV, left ventricular.
Fig. 3
Fig. 3
Cardiac magnetic resonance imaging. Upper: clear demonstration of paired LV clefts (white arrows) in diastole. Lower: pair of LV clefts (white arrows) nearly obliterated in systole. LV, left ventricular.
See this image and copyright information in PMC

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