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Isolated anomalous inferior vena cava with azygos drainage
E K Ramsaran1, A W Filiberti, D H Spodick
1Division of Cardiology, Saint Vincent Hospital, Worcester, MA 01604, USA.
Insights
A rare congenital anomaly, anomalous inferior vena cava drainage via the azygos vein, was discovered in a 79-year-old patient. This isolated finding in adulthood suggests it can be benign when unassociated with other congenital conditions.
Area of Science:
- Cardiology
- Vascular Anatomy
- Medical Imaging
Background:
- Congenital anomalies of the inferior vena cava (IVC) are typically diagnosed in pediatric patients.
- Anomalous drainage of the IVC is often associated with other congenital heart defects.
- The azygos vein typically drains deoxygenated blood from the posterior thoracic wall into the superior vena cava.
Observation:
- A 79-year-old female presented with shortness of breath.
- Cardiac catheterization via the femoral vein was challenging due to difficulty accessing the right heart.
- Venography demonstrated an anomalous drainage of the inferior vena cava into a dilated azygos vein.
Findings:
- The anomalous drainage allowed for successful subsequent catheterization.
- This case represents a rare instance of an isolated congenital IVC anomaly discovered in adulthood.
- The anomaly was identified as a dilated azygos vein receiving drainage from the IVC.
Implications:
- Difficulties during cardiac catheterization may indicate rare congenital vascular anomalies.
- Isolated anomalous inferior vena cava drainage via the azygos vein can be a benign condition.
- This case highlights the importance of considering congenital anomalies even in elderly patients presenting with unusual symptoms.
Abstract:
In a 79-year-old female with shortness of breath, catheterization via the femoral vein encountered difficulty entering the right heart; venography revealed anomalous drainage of the inferior vena cava via a dilated azygos vein permitting subsequent catheterization. Similar difficulties during catheterization merit consideration of this congenital anomaly, which is virtually always discovered in the pediatric population in association with other congenital anomalies. Its unique discovery at advanced age indicates its benignity as an isolated abnormality.