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Persistent left superior vena cava and associated structural and functional considerations
Insights
This study highlights potential links between unusual systemic venous return, such as a left superior vena cava, and atrial fibrillation in an elderly patient. These venous anomalies may contribute to unexplained arrhythmias, warranting coronary sinus assessment.
Area of Science:
- Cardiology
- Vascular Anatomy
- Electrophysiology
Background:
- Systemic venous return anomalies can present complex clinical scenarios.
- Atrial fibrillation is a common arrhythmia with multifactorial causes.
- Cor triatriatum is a rare congenital heart defect affecting atrial septation.
Observation:
- An elderly woman presented with a rare combination of anomalous systemic venous return.
- The anomalies included a left superior vena cava and a persistent left hepatic vein draining into the coronary sinus.
- A forme fruste of cor triatriatum was also noted in the absence of other structural or functional deficits.
Findings:
- A potentially significant association was identified between these systemic venous anomalies and a history of atrial fibrillation.
- The specific combination of bilateral superior venae cavae and a persistent left hepatic vein draining into the coronary sinus is rare.
- The absence of other cardiac defects made it challenging to determine the exact prevalence of these anomalies.
Implications:
- Systemic venous anomalies, particularly those involving the coronary sinus, should be considered in patients with unexplained arrhythmias.
- Assessment of coronary sinus size is recommended for patients presenting with atrial fibrillation.
- Understanding these rare anatomical variations is crucial for accurate diagnosis and management of cardiac arrhythmias.
Abstract:
Potentially significant associations are presented between anomalous systemic venous return (including both left superior vena cava and left hepatic venous drainage to the coronary sinus), a history of atrial fibrillation and a forme fruste of cor triatriatum in an elderly woman. Lack of associated structural defects or functional deficits makes it difficult to assess the frequency of occurrence in the general population of bilateral superior venae cavae in association with a persistent left hepatic vein draining into the coronary sinus. However, the potential for these systemic venous anomalies needs to be considered when unexplained arrhythmias are encountered. More specifically, the size of the coronary sinus needs to be assessed in patients with arrhythmia.