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Persistence of the left superior vena cava (LSVC) is an uncommon congenital disorder, which is normally asymptomatic. Nevertheless, it can create difficulty during central venous and pulmonary artery catheterization.We present a patient with LSVC that was discovered upon radiological confirmation of the correct placement of a pulmonary artery catheter. Case reportThe patient was a 67-yr-old woman with a history of arterial hypertension and posteroinferior myocardial infarction, who was being treated with nitrites, betablockers and angiotensin converting enzyme inhibitors. On arrival in the emergency room, she presented with arrhythmias and dyspnoea with vegetative signs. Presyncope and a rhythm disorder, attributed to an overdose of beta-blockers, were initially suspected. During her hospital stay, ECG confirmed the diagnosis of angina with anteroseptal ischaemia. Catheterization disclosed the presence of a lesion involving the cicumflex artery, anterior descending artery and the middle third of the right coronary artery. She was scheduled to undergo myocardial revascularization with extracorporeal circulation (ECC).In the operating room, central venous pressure was easily monitored via the right internal jugular vein. During surgery, the right atrium and aorta were cannulated and cardioplegia was administered through the CAN J ANAESTH 1996 / 43:6 / pp626-8

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