Authors : Kamran Mirza M; Musthafa Janeel M; Jayaraj A; Raghuram G; Musthafa Mohammad P.P; Nandakumar V

Volume/Issue : Volume 8 - 2023, Issue 7 - July

Google Scholar : https://bit.ly/3TmGbDi

Scribd : https://tinyurl.com/4sfy46zm

DOI : https://doi.org/10.5281/zenodo.8285830

Abstract : Background: Anomalous systemic venous connection with the left atrium per se is a very rare cause of desaturation.The purpose of presenting this particular case is to make emphasis on evaluating the patients with isolated cyanosis meticulously. We have tried to review the previously reported cases of such anomaly under the discussion part. Case presentation: 24-years-old young healthy lady developed symptoms of mild respiratory infection and had gone to a nearby physician Echocardiography showed that heart chambers, ejection fraction, and pulmonary artery pressure were normal. She underwent further evaluation with an HRCT and echocardiogram because of unexplained persistent desaturation. Her HRCT revealed no parenchymal lung changes which could explain desaturation. On Echocardiography, right SVC to left atrium was suspected. Chest Computed Tomography (CT) obtained after contrast material injection into the right arm vein confirmed the large right sided superior vena cava (SVC) and a small persistent left SVC draining into left atrium (LA) which explained low saturation being a significant right-to-left shunt caused by the right-sided superior vena cava (SVC) draining into the left atrium Eventually patient was referred to surgery. Conclusions: Patient who has unexplained desaturation on clinical examination should be looked with suspicion of having anomalous systemic venous drainage. In these suspected cases of RSVC into the LA, cardiac catheterization should be performed to rule out other intracardiac lesions and to evaluate pulmonary venous drainage, and right ventricular size if there are no other definite contraindications to use contrast.

Keywords : Partial anomalous systemic venous drainage, Cyanosis, Left atrium.