Dual-chamber pacing via a persistent left superior vena cava in a patient with Turner's syndrome

Area of Science:

• Cardiology
• Congenital Heart Disease
• Medical Genetics

Background:

• Persistent left superior vena cava (PLSVC) is a congenital anomaly where the left superior vena cava drains into the left atrium.
• PLSVC frequently coexists with other cardiovascular malformations, potentially complicating clinical management.
• Turner's syndrome is a genetic disorder affecting females, often associated with cardiovascular abnormalities.

Observation:

• A 50-year-old female patient presented with complete heart block.
• The patient had a known diagnosis of coarctation of the aorta.
• A persistent left superior vena cava was identified as an incidental finding.

Findings:

• The presence of PLSVC complicated the successful positioning of intravenous pacing electrodes for a dual-chamber pacemaker.
• This case represents a previously unreported association between PLSVC, coarctation of the aorta, and Turner's syndrome.
• Complete heart block necessitated the urgent implantation of a dual-chamber pacemaker.

Implications:

• This case underscores the importance of recognizing rare congenital anomalies like PLSVC in patients with complex cardiac conditions.
• Awareness of this specific association can aid clinicians in anticipating and managing challenges during cardiac device implantation.
• Further investigation into the prevalence and clinical significance of PLSVC in conjunction with coarctation of the aorta and Turner's syndrome is warranted.