An unusual case of ventricular ectopy in a military pilot.

BACKGROUND: Congenital left ventricular diverticula are an uncommon cardiac malformation. Although they may be asymptomatic, their presence is important to note as they are associated with systemic embolization of mural thrombus, valvular regurgitation, heart failure, focal ventricular arrhythmias, and sudden death. CASE REPORT: We describe a case of an asymptomatic pilot with a significant burden of ventricular ectopy. The diagnosis of a large left ventricular diverticulum was made by cardiac CT and confirmed by cardiac magnetic resonance imaging. No specific treatment was warranted; however, regular on-going follow up was required. DISCUSSION: It is important to seek out a structural cause for frequent ventricular ectopy even in the absence of symptoms. Transthoracic echocardiography is not always able to delineate the entire left ventricular cavity and other imaging modalities such as ECG-gated cardiac CT or gated MRI may need to be used in conjunction to permit assessment for the presence of structural heart disease in the whole heart. Aircrew with a high burden of ectopy require regular follow-up for complications such as more malignant dysrhythmias or LV impairment. In some cases, pharmacological or even surgical treatment is warranted, which may have a significant bearing for the future licensing of aircrew.

Familial multiple ventricular extrasystoles, short stature, craniofacial abnormalities and digital hypoplasia: a further case of Stoll syndrome?

We report two brothers, their mother and a maternal cousin who had a distinctive facial phenotype, mild brachydactyly and prominence of the interphalangeal joints. One brother and the mother also had multiple ventricular extrasystoles. Six other relatives in four generations were probably affected on the basis of history and family photographs. We also report a further individual from a different family with a similar facial phenotype, Pierre-Robin sequence, tapering fingers and multiple ventricular extrasystoles. These families have some similarities to those reported by Stoll et al. in a single family, showing dominant inheritance. Our patients would seem to have the same or a related condition.

Ventricular bigeminy misdiagnosed as fetal bradycardia by cardiotocography--the value of non-invasive fetal electrocardiography.

We document the value of non-invasive fetal electrocardiography (fECG) in a case of fetal arrhythmia in which an unnecessary cesarean section was almost performed. The fetal heart rate (fHR) was 60-70 beats per minute (bpm) on the cardiotocography (CTG), with occasional, sudden fluctuations to 130 bpm. This was probably a result of the technical limitations of the CTG.

Isolated congenital left ventricular diverticulum with perinatal dysrhythmia: a case report and review of the literature.

We report a case of isolated congenital left ventricular diverticulum (LVD) with perinatal dysrhythmia, which disappeared spontaneously 1 week after birth. The LVD arose from the lateral wall of the LV, and the contraction of the LVD was synchronous with the kinetics of the main LV chamber. The LVD changed very little in size during the first 30 months after birth, and its relative size to the growing LV main chamber decreased. The patient had neither any symptoms nor complications during this time. The available literature on prenatal and neonatal cases with isolated LVD or LV aneurysm is also reviewed.