A Tale of Two Apexes: Diagnostic Challenges and the Role of Multimodality Imaging in Left Ventricular Apex Anomalies

• Unusual anatomic variations may be overlooked in a routine cardiac workup. • LVAH and diverticulum exemplify diagnostic challenges. • A focused examination of the LV apex is crucial to uncover subtle regional anomalies. • Multimodality imaging may improve detailed LV apex imaging.