Multiple thromboembolic events associated with bilateral superior vena cava and anomalous drainage into the left atrium
- 1 February 2021
- journal article
- research article
- Published by BMJ in BMJ Case Reports
- Vol. 14 (2), e237401
- https://doi.org/10.1136/bcr-2020-237401
Abstract
A 49-year-old female patient presented with acute-on-chronic chest pain. She was diagnosed with multiple systemic thromboemboli, including myocardial infarctions, bilateral chronic pulmonary emboli, ischaemic stroke, deep venous thrombosis and superficial thrombophlebitis. She had a background of sickle cell trait. Cardiac magnetic resonance showed bilateral superior vena cava (SVC). The right-sided SVC (RSVC) was joined by the right upper pulmonary vein and drained anomalously into the left atrium. This caused a small volume right to left shunt. The persistent left SVC drained into the right atrium (RA) via a dilated coronary sinus. The overall clinical impression was recurrent paradoxical emboli due to anomalous venous anatomy with a thrombophilia secondary to sickle cell trait. In the normal embryo, the right common cardinal vein develops to become the RSVC, which drains into the RA by term.Keywords
This publication has 31 references indexed in Scilit:
- Anomalous Vena Caval Return to the Left AtriumCirculation, 2012
- Partial Anomalous Pulmonary Venous Return Presenting with Adult‐Onset Pulmonary HypertensionPulmonary Circulation, 2012
- Complications Associated with Sickle Cell Trait: A Brief Narrative ReviewThe American Journal of Medicine, 2009
- Pathophysiology of Congenital Heart Disease in the AdultCirculation, 2008
- Sickle cell trait and the risk of venous thromboembolism among blacksBlood, 2007
- Persistent left superior vena cava: Case reports and clinical implicationsInternational Journal of Cardiology, 2006
- Acute and Chronic Pulmonary Emboli: Angiography–CT CorrelationAmerican Journal of Roentgenology, 2006
- Percutaneous closure of a persistent left superior vena cava connected to the left atriumInternational Journal of Cardiology, 2006
- Persistent left superior vena cava. Use of an innominate vein between left and right superior caval veins for the placement of a right ventricular lead during ICD/CRT implantationEuropean Heart Journal, 2005
- Echocardiography of the coronary sinus in adultsClinical Cardiology, 2000