Multiple and recurrent systemic thrombotic events associated with congenital anomaly of inferior vena cava

Area of Science:

• Vascular Surgery
• Cardiology
• Radiology

Background:

• Inferior vena cava (IVC) anomalies are rare congenital conditions.
• Thrombosis is a common clinical problem, often associated with risk factors like immobility and genetic predisposition.

Observation:

• A 67-year-old woman with a history of cerebral infarction and pulmonary embolism presented with chest pain.
• Diagnosis of acute myocardial infarction and deep vein thrombosis (DVT) was established.
• Imaging revealed congenital absence of the infra-renal IVC, with venous drainage rerouted through an ascending lumbar vein.

Findings:

• The patient's presentation of acute myocardial infarction and DVT occurred in the context of a rare congenital IVC anomaly.
• Congenital absence of the infra-renal IVC is associated with altered venous hemodynamics.
• The ascending lumbar vein served as an alternative drainage pathway for lower extremity venous return.

Implications:

• This case highlights the importance of considering rare anatomical variations in the diagnosis of thromboembolic events.
• Congenital IVC anomalies may represent an underrecognized risk factor for venous thromboembolism.
• Further research is warranted to elucidate the precise mechanisms linking IVC anomalies to thrombosis.