An approximately 33-year-old male blue and gold macaw (Ara ararauna) was presented for postmortem examination after dying without premonitory signs at the owner's home. The bird had a recent history of a grade II/VI left-sided systolic murmur, feather-destructive behavior, was overweight, and had bilateral cataracts. Gross and microscopic postmortem examinations revealed a subaortic interventricular septal saccular defect most compatible with a diverticulum intimately associated with a multifocally fibrotic right coronary aortic semilunar cusp, and its distended sinus. The resulting congestive heart disease was morphologically characterized by concentric myocardial hypertrophy of the left ventricle and cardiogenic pulmonary edema. Reports of cardiac congenital disease in birds include ventricular septal defects, congenital aneurysm, persistent truncus arteriosus, aortic hypoplasia, duplicitas cordis, multiplicatis cordis, and ectopia cordis. To the best of the authors' knowledge, this is the first documentation of a subaortic interventricular septal saccular defect in an avian species. This case adds to the knowledge of cardiovascular disease and raises awareness of delayed-onset clinical disease linked with congenital heart anomalies in birds.

Ventricular diverticula can be divided into congenital and acquired ventricular diverticulum. Cardiac rupture is a rare occurrence of cardiac injury, but the mortality rate is very high. Some cardiac ruptures may form an acquired ventricular diverticulum. We report the case of a 57-year-old man who presented with a right ventricular diverticulum caused by traumatic ventricle rupture.A 57-year-old man was admitted with chest pain and dyspnea after falling from a high place. His condition gradually stabilized after emergency surgery and rescue treatment. One week later, the patient suddenly presented with swelling of the right upper limb. Venous thrombosis in the right upper extremity was detected by vascular color ultrasound. Further pulmonary artery computed tomography angiography (CTA) revealed an upper right pulmonary artery embolism and a diverticulum in the right ventricular wall; no obvious diverticulum or pericardial effusion was found by echocardiography. After a thorough discussion with the cardiac surgeon, anticoagulant therapy was administered and his condition was closely monitored. After 10 days, pulmonary CTA showed that the pulmonary thrombus had disappeared, but the right ventricular diverticulum was more prominent than before; therefore, anticoagulant therapy was stopped, although hemostatic drugs were not administered. The right ventricular diverticulum gradually shrank and healed.Asymptomatic cardiac diverticula may resolve spontaneously with conservative treatment. 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.

Congenital cardiac diverticula are rare malformations involving the myocardium, the endocardium, and occasionally the pericardium. They have variable presentations and are often incidental findings. A 61-year-old man with no significant history presented worsening exertional dyspnea. Examination revealed obesity but was otherwise unremarkable. Initial tests were normal, but chest radiography showed cardiomegaly and ECG indicated diffuse microvoltage. Echocardiography revealed a large left ventricular diverticulum (7 × 8 cm) with a wide neck (4 cm) and severe dysfunction (EF 30 %). Coronary angiography confirmed normal coronary arteries. Despite intensive care, his condition deteriorated and required mechanical ventilation and vasoactive support. He underwent emergency surgery but succumbed intraoperatively. Although rare, congenital cardiac diverticula can cause severe complications, including heart failure and sudden death. Echocardiography is the key to diagnosis, with CT or MRI providing further characterization. Surgery is the preferred treatment for symptomatic cases, while asymptomatic patients require close follow-up. This case highlights the need for early diagnosis and timely intervention in congenital cardiac diverticula to prevent fatal outcomes.

Double-chambered left ventricle (DCLV) is a rare congenital condition, and few case reports are mentioned in literature. Entity, clinical course, and prognosis remain unclear. Cardiovascular magnetic resonance (CMR) is often used for characterization of various congenital heart diseases and can be particularly useful for imaging rare phenomena. Three cases of DCLV were detected by CMR within 2 years in our CMR centre with and without associated congenital heart disease or hypertrabecularization. The patients did not suffer from cardiac symptoms despite the presence of premature ventricular complexes in one patient. Diagnosis of DCLV was made based on a first CMR study that was performed in adulthood, although some anatomical suspicion was already raised by previous echocardiography. Double-chambered left ventricle, synonymous with the terminus 'cor triventriculare sinistrum', has been previously perceived as a rare phenomenon compared with double-chambered right ventricle. It has to be distinguished from ventricular aneurysm or cardiac diverticulum and is characterized by an additional contractile septum with normal wall structure that divides the LV cavum into two (rather) same-sized chambers. The prognosis seems to be benign, since there is no restriction in functionality and no increased thrombogenicity until adulthood. Consequently, there is (presumably) no need for a tailored therapy-at least in the cases present here. Accordingly, we recommend follow-up CMR examinations for progress monitoring and recognize CMR's significant role for diagnosis and follow-up of cardiac abnormalities in orphan diseases. Due to its broader availability, we expect further cases of DLVC in the future.