Objective:

To summarize clinical characteristics, imaging features, associated anomalies, treatment approaches, and outcomes of congenital left ventricular diverticulum (LVCD) based on a systematic review of the literature, emphasizing the need for improved understanding and management.

Key Findings:

• LVCD is a rare congenital anomaly characterized by a localized outpouching of the left ventricular wall, which retains contractile function.
• Clinical presentations vary widely, from asymptomatic cases to severe complications like heart failure and systemic embolism, highlighting the need for careful monitoring.
• Echocardiography is the first-line imaging tool, often supplemented by CMR or CT for detailed anatomical assessment, crucial for accurate diagnosis.
• No standardized management guidelines exist; treatment is individualized based on symptoms, associated risks, and patient-specific factors.

Interpretation:

The review highlights the complexity and variability in the clinical presentation and management of LVCD, emphasizing the need for individualized treatment approaches tailored to each patient's unique circumstances.

Limitations:

• The review is based on case reports and small series, which may limit the generalizability of findings and introduce potential biases.
• The natural history of LVCD in asymptomatic patients remains poorly understood, necessitating further investigation.

Conclusion:

This comprehensive review provides a foundation for better understanding and managing congenital LVCD, although further research is needed to establish standardized treatment protocols and improve patient outcomes.