Survival after right ventricular diverticulum caused by right ventricular rupture: Case report and brief review of the literature

Abstract

Abstract Background Ventricular diverticulum can be divided into congenital and acquired diverticulum. Cardiac rupture is a rare occurrence of cardiac injury, but the mortality rate is very high. Part of cardiac rupture may form an acquired ventricular diverticulum. Here, we present a case of a 57-year-old man presenting with right ventricular diverticulum caused by traumatic ventricle rupture. Case presentation: A 57-year-old man was admitted with chest pain and dyspnea after falling from a high place. The patient's condition gradually stabilized after emergency surgery and rescue treatment measures. One week later, the patient suddenly presented with swelling of the right upper limb. Right upper extremity venous thrombosis was detected by vascular color ultrasound. Further pulmonary artery computed tomography angiography (CTA) examination revealed an upper right pulmonary artery embolism and a diverticulum in the right ventricular wall; however, no obvious diverticulum or pericardial effusion was found by echocardiography. After a thorough discussion with the cardiac surgeon, it was decided that anticoagulant therapy should be given under close monitoring. After ten days, pulmonary CTA showed that the pulmonary thrombus had disappeared, but the right ventricular diverticulum was more prominent than before, so anticoagulant therapy was stopped, but hemostatic drugs were not given. Finally, the right ventricular diverticulum gradually shrinks and heals. Conclusions Although certain imaging features exist, the missed diagnosis of occult cardiac diverticulum cannot be ignored. We learned from this case that the diagnostic value of cardiac CTA or pulmonary artery CTA for occult heart injury might be superior to that of cardiac ultrasound.