Persistent Left Superior Vena Cava with Absent Right
Superior Vena Cava: A
Case Report: and Literature Review
Leedumrongwattanakul A, MD¹,³, Ruamcharoenkiat S, MD², Herwutthiwong P, BSc², Leelarasamee A, MD³
Affiliation : ¹ Cardiology Unit, Department of Medicine, Pranangklao Hospital, Nonthaburi, Thailand ² Department of Radiology, Pranangklao Hospital, Nonthaburi, Thailand ³ Faculty of Medicine, Siam University, Bangkok, Thailand
A 71-year-old man presented with drowsiness three hours before admission. Stroke or hepatic encephalopathy was suspected but
computed tomography (CT) scan of the brain revealed no abnormality. Cardiac auscultation discovered pansystolic murmurs at
apex radiated to axilla. Plain chest roentgenogram showed markedly cardiac enlargement and electrocardiogram (ECG) revealed
atrial fibrillation. Transthoracic echocardiography was performed to detect the etiology of cardiac enlargement, but it discovered
a dilated coronary sinus instead. Finally, a very rare case of persistent left superior vena cava (PLSVC) with absence of right
superior vena cava (RSVC) anomaly that is also known as isolated PVSVC was incidentally demonstrated by transesophageal
echocardiography. The patient also had severe mitral and tricuspid regurgitations. Diabetes mellitus, dyslipidemia, and suspected
cirrhosis of liver were also found. He was treated for hepatic encephalopathy, which is not related to PLSVC and he recovered
uneventfully. PLSVC should be expected if any intracardiac venous procedures are going to be performed such as central venous
catheterization, device implantation, or coronary artery bypass surgery.
Keywords : Persistent left superior vena cava, Congenital venous anomaly, Dilated coronary sinus, Echocardiography
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