Unexplained Double‐Chambered Left Ventricle Associated with Contracting Right Ventricular Aneurysm and Right Atrial Enlargement

Finocchiaro, Gherardo; Murphy, Daniel J.; Pavlović, Aleksandra; Haddad, François; Shiran, Hadas; Sinagra, Gianfranco; Ashley, Euan A.; Knowles, Joshua

doi:10.1111/echo.12467

Cited by 8 publications

(11 citation statements)

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“…Flow velocity across the accessory ventricular septum was 1.1 ±0.3 m/s during systole, 1,29,31 and was 1.0 ±0.3 m/s during diastole. 29,31 The intra-left ventricle pressure gradient before treatment was reported for 8 patients: it was zero in five patients, 2,6,12,13,28 (it rose to 55 mmHg after exercise in one of them 12 ). Their mean pressure gradient was 30.1 ±46.2 mmHg (n=8).…”

Section: Resultsmentioning

confidence: 99%

“…There were 10 (34.5%) pediatric patients (including the fetal case), 2,6,11,13,16,17,19,[28][29][30] and 19 (65.5%) adult patients ( 2 =5.59, p=0.035). 1,5,[7][8][9][10]12,14,15,18,[20][21][22][23][24][25][26][27]31 Fourteen patients (48.3%) were asymptomatic, 2,6,8,13,14,16,17,[22][23][24]26,27,29,31 while 15 (51.7%) were symptomatic ( 2 =0.00, p=1.000). 1,5,7,[9][10][11][12]15,…”

Section: Resultsmentioning

confidence: 99%

“…1,5,[7][8][9][10]12,14,15,18,[20][21][22][23][24][25][26][27]31 Fourteen patients (48.3%) were asymptomatic, 2,6,8,13,14,16,17,[22][23][24]26,27,29,31 while 15 (51.7%) were symptomatic ( 2 =0.00, p=1.000). 1,5,7,[9][10][11][12]15,[18][19][20][21]25,28,30 Among 14 asymptomatic patients, 6 (42.9%) were pediatrics (including the fetal case), and 8 (57.1%) were adults ( 2 =0.57, p=0.706). There were 31 clinical presentations in 15 symptomatic patients, where the most common symptoms were chest pain and palpitation.…”

Section: Resultsmentioning

confidence: 99%

“…Heart murmur was described in 13 (13/29, 44.8%) patients: in 4 (4/13, 30.8%) patients, no heart murmur was audible, 2,18,25,31 and in 9 (69.2%) patients, a systolic murmur was heard ( 2 =3.85, p=0.115). 1,5,6,11,12,21,28,30 The locations of the murmurs were: left sternal border (n=4), 1,11,12,30 apex (n=2), 21,28 base (n=1), 5 mesocardiac area (n=1), 6 and unspecified (n=1). 23 In 20 pateints, their electrocardiographic (ECG) findings were available: the ECG findings were normal in 6 (30%) patients.…”

Section: Resultsmentioning

confidence: 99%

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Double-chambered Left Ventricle: Clinical Features Comparison between Children and Adults

Yuan

2019

J Coll Physicians Surg Pak

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Double-chambered left ventricle is a rare congenital heart defect. The clinical features, diagnosis, treatment and patient prognosis of this lesion have not been sufficiently elaborated. The present systematic review found that the accessory ventricular septum was often an abnormal muscle band, and sometimes a membranous structure, a fibromuscular ridge, or prominent trabeculations. Less than one-third of the patients are associated with other congenital heart defects. Diagnosis of double-chambered left ventricle can usually be made by transthoracic echocardiography; however, it might be misdiagnosed as atrial or ventricular septal defect. The accessory chamber was often smaller than the main chamber, and often has wall thinning. The accessory chamber wall dysfunction/hypokinesis was seen in half of the cases. One-third patients had left ventricular outflow tract obstruction. The adult patients showed abnormal electrocardiographic findings more than in pediatrics. Nevertheless, no differences were found between adult and pediatric patients in terms of left ventricular function and structure, treatment of choice, and patient outcomes. Most patients are asymptomatic with no left ventricular obstruction, and thus do not need surgical treatment. Surgical resection of the accessory ventricular septum is warranted when the patients become symptomatic as a result of left ventricular obstruction, or associated with other congenital heart defects. The patients' outcomes are promising. Differential diagnosis should be made from other types of left ventricular outpouching, other congenital heart defects, and left ventricular non-compaction.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Double-chambered Left Ventricle: Clinical Features Comparison between Children and Adults

Yuan

2019

J Coll Physicians Surg Pak

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“…The occurrence of DCLV is even rarer than that of double‐chambered right ventricles. Only a few cases of DCLV have been reported in local and international literature . The causes of DCLV are currently unclear and may be related to the hypoplasia of the regional myocardial intratrabecular sinusoids or an intramyocardial aneurysm during the embryonic period .…”

Section: Discussionmentioning

confidence: 99%

Double‐chambered left ventricle: A rare case in a child

et al. 2018

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Double-chambered left ventricle (DCLV) is an extremely rare congenital heart disease. In this condition, the left ventricle (LV) is divided into the main left ventricular chamber (MLVC) and the accessory chamber (AC) by a septum or muscle fiber with abnormal proliferation. The MLVC and AC chambers are connected to each other and can be classified into different types on the basis of their positions. Many researchers have different opinions regarding this disease. 1 | C A S E PRE S ENTATI ONA boy was diagnosed with DCLV at our hospital. The pathological type, diagnostic points, and therapeutic schemes of this condition were considered in the context of current and relevant local and international studies and reports on DCLV. The 9-year-old boy was admitted with the major complaint of 8 years of cardiac murmur, which was originally diagnosed through physical examination when the boy was 9 months old, and 5 years of palpitations and shortness of breath. Echocardiographic examination showed that the boy has congenital heart disease and an atrial septal defect (ASD) with a length of 4 mm. The patient is always being followed up because of his slight ASD. Over the past 5 years, the patient has often experienced palpitations and shortness of breath when participating in strenuous activities. The patient's uncomfortable symptoms intensified 10 days before hospital admission.Admission examination revealed that the boy had a blood pressure of 100/62 mm Hg and heart rate of 74 times/min. The patient also exhibited nonpalpable tremors, slightly enlarged heart borders, regular cardiac rhythm, loud heart sound, and murmur in the left 3-4 sternum during the systolic period (II/III level).Coarse breathing sounds were heard in both lungs. Cyanosis and precordium abnormal uplift were not observed. The boy's liver, spleen, and subcostal areas were intangible, and his lower limbs were not edemic. The results of 12-lead electrocardiogram (ECG) and Holter monitoring obtained through aided examination indicated sinus arrhythmia with left axis deviation (Figure 1). Chest X-ray revealed an abnormal cardiac shape, as well as the localized protrusion of the left anterior margin of the heart (Figure 2).Echocardiography taken along the left ventricular long axis with an apical four-chamber view showed that the left chamber was obliquely separated into left and right chambers by abnormal muscle bundles. In the parasternal long-axis view, the size of the MLVC was 4.2 × 3.9 cm and that of the AC was 2.1 × 1.8 cm. A wide access hole with the diameter of 1.9 cm during the systolic period was found between the MLVC and AC. The flow rate from the How to cite this article: Zhang W-M, Chang D-Q, Huang J-J, et al. Double-chambered left ventricle: A rare case in a child.

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