Left ventricular diverticulum is a very rare entity to be found in adults. Noninvasive echocardiography can offer useful information prior to contrast-enhanced computer tomography or invasive angiography. We evaluated a patient with left ventricular apical diverticulum but complained no symptoms. Transthoracic echocardiography demonstrated a outpouching at left ventricle apex. A 640-slice computed tomography later confirmed the left ventricular diverticulum.

Background: Invasive coronary angiography is the gold standard for assessing in-stent restenosis (ISR) in patients with coronary artery disease. However, the predictive value of non-invasive Tissue Doppler Imaging (TDI) to evaluate patients with ISR has not been studied extensively. Methods: A total of 41 patients (19 with acute myocardial infarction and 22 with stable angina pectoris) who received percutaneous coronary intervention (PCI) were enrolled in the study. Time-to-peak velocities (TpV) of 12 non-apical segments of the left ventricle, by pulse wave TDI echocardiography, were obtained within two days prior to the PCI and six months later. Results: A 12-segmental mean TpV ≥ 279.6 ms at six months after PCI was able to detect ISR (odds ratio: 2.09, 95% CI 1.004–4.352, p = 0.049). Moreover, a significant decrease in the standard deviation of TpV was demonstrated in patients without ISR (85.8 ± 44.8 vs. 60.3 ± 31.7 ms, p = 0.001), but not in patients with ISR (97.7 ± 53.3 vs. 91.2 ± 52.6 ms, p = 0.57). Conclusions: Pulse-wave TDI echocardiography is a promising tool in the detection of ISR six months after PCI in patients with coronary artery disease.