Isolated congenital left ventricular diverticulum in adult: an unusual finding in a cocaine-associated myocardial infarction

Congenital left ventricular diverticulum (CLVD) consists of an out-pouching of endocardium, myocardium, and pericardium, which often presents as a projection from the ventricular free wall, with a narrow neck connecting the cavity to the ventricle proper. Although it is often associated with other cardiac and extracardiac congenital anomalies, it may also present alone, as an incidental finding in adult patients. Due to its low overall prevalence and variability in presentation, a standardized treatment has yet to be delineated. We present the case of an adult patient with cocaine-associated myocardial infarction (MI), in which a septal CLVD was revealed by coronary computed tomography (CT) angiography. Other cardiac anomalies were ruled out and, the patient responded well to medical treatment after cardiac catheterization; thus, medical follow-up was preferred and did not surgery.