Myocardial cleft, crypt, diverticulum, or aneurysm? Does it really matter?

Myocardial clefts are congenital abnormalities related to myocardial fiber or fascicle disarray that have been described in healthy volunteers as well as in the setting of hypertrophic cardiomyopathy. A cleft or crypt can be described as a discrete, approximately "V" shaped fissure extending into but confined by the myocardium, with a tendency to narrow or occlude in systole without local hypokinesia or dyskinesia. While little is known about the clinical significance of this entity, this report elaborates on the confounding terminology and differential diagnosis of this condition.