Partial Anomalous Pulmonary Venous Connection: A Great Imitator?

Area of Science:

• Cardiology
• Thoracic Surgery
• Pulmonary Medicine

Background:

• Partial anomalous pulmonary venous connections (PAPVC) involve abnormal pulmonary vein drainage into the systemic circulation, creating an extracardiac shunt.
• Isolated, singular PAPVCs are typically hemodynamically insignificant and asymptomatic.

Observation:

• A young Caribbean-Black woman presented with recurrent pleural effusions.
• Her condition was complicated by catamenial pleural endometriosis.
• Diagnostic workup revealed an isolated, singular PAPVC from the left inferior pulmonary vein to the left innominate vein.

Findings:

• The singular PAPVC was unexpectedly hemodynamically significant.
• The clinical presentation was masked by symptoms related to endometriosis.

Implications:

• This case underscores the potential for hemodynamically significant isolated PAPVC, even with a single aberrant vessel.
• It highlights the importance of considering complex cardiovascular anomalies in patients with unexplained symptoms, especially when co-occurring conditions like endometriosis can obscure diagnosis.
• This presentation expands the understanding of PAPVC clinical variability and diagnostic challenges.