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Logo of ihjGuide for AuthorsAbout this journalExplore this journalIndian Heart Journal
 
Indian Heart J. 2016 May-Jun; 68(3): 376–377.
Published online 2016 January 13. doi:  10.1016/j.ihj.2015.12.021
PMCID: PMC4911458

A huge echolucent structure resembling cyst adjacent to left atrium: Revealing persistent left superior vena cava with 4D echocardiography

Levent Cerit[low asterisk]
Fellow of Cardiology, Near East University Hospital, Department of Cardiology, Nicosia, Cyprus
Hamza Duygu
Professor of Cardiology, Near East University Hospital, Department of Cardiology, Nicosia, Cyprus

Persistent left superior vena cava (PLSVC) is the most common congenital thoracic venous anomaly with a prevalence of 0.3–0.5%.1, 2, 3, 4 PLSVC can be associated with other cardiovascular abnormalities such as atrial septal defect, bicuspid aortic valve, coarctation of aorta, coronary sinus ostial atresia, and cor triatriatum.5 A 81-year-old male was admitted to syncope and palpitation. He had history of hypertension and paroxysmal atrial fibrillation. Physical examination was normal. Cranial MRI was normal. 2D and 4D transthoracic echocardiography revealed normal findings except moderate mitral regurgitation and a hugely dilated coronary sinus suggestive of a PLSVC in apical 4-chamber view (Fig. 1). Agitated saline contrast study from the left antecubital vein demonstrated prior contrast enhancement of this giant coronary sinus before the right atrium on 2D and 4D transthoracic echocardiography (Fig. 2). We thought his syncope attack due to orthostatic hypotension. The patient was discharged with warfarin, angiotensin-converting enzyme inhibitor, and beta-blocker.

Fig. 1
Persistent left superior vena cava mimicking left atrial cyst on 2D and 4D echocardiography.
Fig. 2
Persistent left superior vena cava on 2D and 4D echocardiography after agitated saline infusion.

Conflicts of interest

The authors have none to declare.

References

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Articles from Indian Heart Journal are provided here courtesy of Elsevier