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Case Reports
. 2013 Sep-Oct;65(5):603-6.
doi: 10.1016/j.ihj.2013.08.024. Epub 2013 Aug 26.

Isolated persistent left-sided superior vena cava, giant coronary sinus, atrial tachycardia and heart failure in a child

Affiliations
Case Reports

Isolated persistent left-sided superior vena cava, giant coronary sinus, atrial tachycardia and heart failure in a child

Nagaraja Moorthy et al. Indian Heart J. 2013 Sep-Oct.

Abstract

Persistence of a left-sided superior vena cava (PLSVC) with absent right superior vena cava (isolated PLSVC) is a very rare venous malformation and commonly associated with congenital heart disease or alterations of the cardiac situs. We describe an unusual case of a young boy presenting with persistent atrial tachycardia and congestive heart failure. He was detected to have unexplained grossly dilated right atrium, right ventricle with systolic dysfunction and a giant coronary sinus (CS). The dilated CS closely mimicked a pseudo cor-triatriatum on echocardiography. Contrast echocardiography from both arms revealed opacification of the CS before the right atrium. Bilateral upper limb venography confirmed the presence of absent right SVC and isolated persistent left SVC draining into the giant coronary sinus.

Keywords: Atrial tachycardia; Congestive heart failure; Coronary sinus; Persistent LSVC.

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Figures

Fig. 1
Fig. 1
12-lead ECG showing atrial tachycardia at a rate of 214/min with 1:1 conduction.
Fig. 2
Fig. 2
A: Transthoracic 3-D echocardiography in parasternal long axis view showing hugely dilated coronary sinus mimicking cor-triatriatum. B: Transthoracic 3-D echocardiography in apical 4 chamber view showing hugely dilated coronary sinus mimicking cor-triatriatum.
Fig. 3
Fig. 3
Contrast echocardiography using agitated saline showing simultaneous opacification of dilated coronary sinus and right atrium and right ventricle.
Fig. 4
Fig. 4
A: Simultaneous bilateral upper limb venography showing absent right SVC and persistent left SVC draining into dilated coronary sinus. B: Simultaneous bilateral upper limb venography showing hugely dilated coronary sinus.

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