Persistent left superior vena cava as an incidental finding in the introduction of a transient pacemaker: A case...

Area of Science:

• Cardiology
• Vascular Anatomy
• Medical Diagnostics

Background:

• Persistent left superior vena cava (PLSVC) is the most prevalent systemic venous drainage anomaly in adults.
• While often asymptomatic, PLSVC can be associated with cardiac rhythm disturbances like tachyarrhythmias and bradyarrhythmias.

Observation:

• A 53-year-old female presented with acute coronary syndrome and unstable bradycardia.
• Initial management included a transvenous pacemaker, which was placed in the left atrium.
• Transthoracic echocardiography was essential for diagnosing the co-existing PLSVC.

Findings:

• The case demonstrates a rare presentation of PLSVC in conjunction with acute coronary syndrome.
• Diagnosis was confirmed via transthoracic echocardiogram, revealing the persistent left superior vena cava anomaly.
• The patient required percutaneous intervention for management.

Implications:

• This case underscores the importance of considering venous anomalies in patients with cardiac conditions.
• Echocardiography plays a crucial role in identifying PLSVC, especially when pacemaker leads are misplaced.
• Timely diagnosis and intervention for PLSVC can lead to favorable patient outcomes.