A 42-year-old male patient was admitted to our
cardiology clinic because of atypical chest pain. He did
not have any relevant medical history, and his physical
examinations and laboratory results revealed no
abnormalities. However, transthoracic echocardiography
showed a large dilated coronary sinus (Figure
1). After
injecting saline into the left antecubital vein, the
contrast first seeped into the coronary sinus and then
the right atrium. Afterwards, when the right antecubital
vein was injected with an agitated saline solution, it
seeped into the dilated coronary sinus and then emptied
into the right atrium. Hence, we suspected there was
a persistent left superior vena cava (PLSVC) with an
absent right superior vena cava (RSVC). In order to
more obviously illustrate this, computed tomography
(CT) was performed, which confirmed our suspicions
(Figure
2-
4).
Figure 1: Echocardiogram showing the dilated coronary sinus (CS).
Figure 2: Computed tomographic image showing the right
superior vena cava (narrow arrow on the left) joining with the left
superior vena cava (thick arrow) and forming the coronary sinus.
Figure 3: Computed tomographic image showing the dilated left
superior vena cava (arrow).
Figure 4: Computed tomographic image showing the absence of
the right superior vena cava (curved arrow) and the dilated left
superior vena cava (arrow).
The presence of a PLSVC with an absent RSVC
is an extremely rare congenital venous anomaly. Furthermore, PLSVCs are generally asymptomatic
and are usually discovered incidentally. Moreover,
this condition often has been reported during the
placement of a pacemaker and a central venous
catheter. Fortunately, because of modern imaging modalities, such as contrast echocardiography, CT, and
magnetic resonance imaging, this anomaly can now be
clearly and easily confirmed.[1-3]
Declaration of conflicting interests
The authors declared no conflicts of interest with
respect to the authorship and/or publication of this
article.
Funding
The authors received no financial support for the
research and/or authorship of this article.