A case of multiple abnormalities: aortic arch anomaly, aberrant left subclavian artery, left atrial diverticulum, and myocardial noncompaction

A 21-year-old male patient presented with atypical chest pain. Examinations with echocardiography, ventriculography, and pulmonary angiography showed multiple abnormalities including an aortic arch anomaly, aberrant origin of the left subclavian artery, connection of the left pulmonary veins to the left atrium via a single root, left atrial diverticulum, and left ventricular myocardial noncompaction. A 24-hour Holter monitoring detected no arrhythmias and the left ventricular systolic function was in normal range. Surgical correction was not considered, so a medical follow-up program was initiated with an angiotensin-converting enzyme inhibitor and aspirin. To our knowledge, association of the above-mentioned anomalies has been hitherto unreported.