Multimodality CMR diagnosis of double-chambered left ventricle in a child: A case report.

rationaleDouble-chambered left ventricle (DCLV) is a rare congenital anomaly in which a muscular band divides the left ventricular cavity into 2 chambers. It may mimic other conditions such as left ventricular noncompaction (LVNC), thrombus, or aneurysm. This case highlights the diagnostic role of multimodality cardiac magnetic resonance (CMR) imaging. PATIENT CONCERNS: We report a 12-year-old girl undergoing anthracycline chemotherapy for pre-B acute lymphoblastic leukemia who presented with non-radiating chest pain for 1 week. Her medical history included patent ductus arteriosus closure at age 2 and ongoing growth hormone therapy for short stature. DIAGNOSES: Diagnosis of DCLV was established based on CMR findings of a bifid apex separated by a synchronously contracting muscular band with myocardial-like signal intensity and absence of late gadolinium enhancement. A trabecular-to-compact ratio of 1.84 further excluded LVNC, and imaging features were inconsistent with diverticulum, thrombus or aneurysm.

interventionsThe patient received no medical or surgical intervention. Given her stable condition and absence of concerning findings on follow-up, she remained under routine clinical observation without the need for further treatment. OUTCOMES: The patient remained asymptomatic during 1 year of follow-up, with no recurrence of chest pain or development of cardiac complications. LESSONS: When DCLV presents with an ambiguous apical mass and abnormal cavity with complex comorbidities, it can mimic serious conditions such as LVNC, thrombus, aneurysm, or diverticulum, making accurate diagnosis challenging using echocardiography alone. In situations where echocardiographic findings are inconclusive, CMR with tissue characterization is essential to avoid misdiagnosis and unnecessary treatment. Early use of multimodality CMR in such cases helps to clarify morphology and guide clinical management.