Acta Cardiologica

ISSN: 0001-5385 (Print) 0373-7934 (Online) Journal homepage: www.tandfonline.com/journals/tacd20

Rapidly progressing coronary artery aneurysm and left
ventricular diverticulum

Osman Sönmez, Abdurrahman Tasal, Gökhan Ertaş & Ahmet Bacaksiz

To cite this article: Osman Sönmez, Abdurrahman Tasal, Gökhan Ertaş & Ahmet Bacaksiz
(2012) Rapidly progressing coronary artery aneurysm and left ventricular diverticulum, Acta
Cardiologica, 67:3, 375-376, DOI: 10.1080/AC.67.3.2160734

To link to this article:  https://doi.org/10.1080/AC.67.3.2160734

Published online: 23 May 2017.

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Address for correspondence: 

Gökhan Ertaş, Assistant Professor, BezmiAlem Foundation University, 
School of Medicine Hospital, Dept. of Cardiology, Istanbul, Turkey. 
E-mail: drgokhanertas@yahoo.com.tr

Received 15 March 2012; accepted for publication 20 March 2012.

A 34-year-old woman with an uncomplicated peri-
partum, developed chest discomfort after operation of 
a ruptured splenic artery aneurysm. A detailed anam-
nesis revealed that the woman had a normal coronary 
angiogram seven years before (figure 1A-C). A 12-lead 
electrocardiogram showed T wave inversion in the 
precordial leads and the cardiac markers were positive. 
Coronary angiography revealed a diffuse aneurysmal 
dilatation in the left main coronary artery (LMCA), the 
left anterior descending (LAD) artery, the circumfex 
coronary (Cx) artery (figure 1B) and the right coronary 
artery (RCA), and also stenotic plaque in RCA (figure 
1B-D). Left ventriculography and echocardiography 
revealed a left ventricular diverticulum (LVD) (figure 
2A-B). Magnetic resonance imaging (MRI) was per-
formed for a differential diagnosis between aneu-
rysm and diverticulum. It revealed and confirmed an 

Rapidly progressing coronary artery aneurysm and left 
ventricular diverticulum 

Osman SÖNMEZ, MD; Abdurrahman TASAL, MD; Gökhan ERTAŞ, MD; Ahmet BACAKSIZ, MD

Department of Cardiology, School of Medicine Hospital, Bezmi Alem Foundation University, Istanbul, Turkey.

anteriorly located contractile diverticulum surrounded 
by normal myocardium (figure 2C-D).

Coronary artery aneurysm (CAA) is defined as a 
localized dilatation of the coronary artery passing the 
diameter of the related normal segment by more than 
50%. It is seen in approximately 1.5-5% of patients 
undergoing coronary angiography1. Congenital ven-
tricular diverticulum is a rare cardiac malformation and 
is defined as a protrusion of the free wall of the ventri-
cles2. To the best of our knowledge, the combined 
presence of aneurysms of the major coronary arteries 
and a left ventricular diverticulum has not been 
described in the literature3. 

CONFLICT OF INTEREST: none declared.

 1. Nichols L, Lagana S, Parwani A. 
Coronary artery aneurysm: 
a review and hypothesis 
regarding etiology. 
Arch Pathol Lab Med 2008; 132: 823-8.

 2. Ohlow MA. Congenital left ventricular 
aneurysms and diverticula: 
definition, pathophysiology, 
clinical relevance and treatment. 
Cardiology 2006; 106: 63-72.

 3. Ohlow MA, Fuhrmann JT, Lauer B. Prevalence 
and spectrum of coronary artery anomalies in 
patients with an isolated congenital left 
ventricular aneurysm or diverticulum. 
Clin Cardiol 2011; 34: 226-32. 

REFERENCES

Acta Cardiol 2012; 67(3): 375-376 doi: 10.2143/AC.67.3.2160734

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G. Ertaş et al.376

Fig. 1 (A) normal left 
coronary arteries; (B) 
aneurysmatic left main 
coronary artery (LMCA), 
left anterior descending 
(LAD), circumflex (Cx); 
(C) normal right coronary 
artery, (D) aneurysmatic 
right coronary artery.

Fig. 2 (A) left 
ventriculography, 
diverticulum with white 
arrows; (B) echocardio-
graphy, diverticulum 
with black arrow; (C-D) 
magnetic resonance 
imaging, diverticulum 
with black arrow, diastolic 
and systolic phase.

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