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[Persistent left superior vena cava with right-left shunt into the left atrium]
B Metzler1, H Hillebrand, H P Eulenbruch
1Klinik Schillerhöhe, Gerlingen, Germany. Metzler@klinik-schillerhoehe.de
Deutsche Medizinische Wochenschrift (1946)
|January 18, 2002
Summary
A rare persistent left superior vena cava was found to connect to the left atrium, causing a right-to-left shunt. This anatomical variant can lead to hypoxemia and erythrocytosis, requiring careful diagnosis.
Area of Science:
- Cardiology
- Anatomical Variants
- Medical Imaging
Background:
- A 72-year-old patient presented with basal ganglia hemorrhage due to hypertensive crisis.
- The patient exhibited severe hypoxemia and erythrocytosis, suggesting a potential right-to-left shunt.
Observation:
- Contrast echocardiography, both transthoracic and transesophageal, was used to investigate the suspected shunt.
- A persistent left superior vena cava was identified, anomalously connecting to the left superior pulmonary vein, not directly to the left atrium.
Findings:
- This previously unreported anatomical variant was confirmed by spiral computed tomography.
- An atrial septal aneurysm was noted, but no other cardiac anomalies were found.
Implications:
- Persistent left superior vena cava with anomalous venous connection should be considered in the differential diagnosis of unexplained hypoxemia and erythrocytosis.
- Contrast echocardiography is a valuable tool for diagnosing persistent left superior vena cava and associated cardiac anomalies.