Congenital diverticulum of the left ventricle is an uncommon cardiac malformation. We present a 45 years old woman, previously asymptomatic. The symptoms and electrocardiogramas suggested ischemic heart disease. The left ventriculogram demonstrated an isolated apical diverticulum, although the coronary arteries were normal. We will consider the etiopathogeny, classification, clinical history, diagnosis and treatment of the isolated apical diverticulum.