Isolated Persistent Left Superior Vena Cava Revealed by an Associated Asthma

Abstract

Background. Persistent left superior vena cava (PLSVC) is a rare anomaly of the thoracic venous system. Case Report. We present a case of a patient with isolated asymptomatic PLSVC, who was diagnosed because of dyspnea revealing an associated asthma. An 18-year-old male patient complained of paroxystic sibilant dyspnea. He did not have any anomaly in physical examination. The chest X-ray revealed cardiomegaly with a widening of lower mediastinum. The electrocardiogram does not show any anomaly. Echocardiography showed the PLSVC. The thoracic contrast computed tomography of the chest showed ecstasies of the right cardiac cavities and a double superior vena cava. The patient did not have similar family cases. Respiratory functional explorations led to the diagnosis of an associated asthma. Currently, he is followed up periodically. Asthma was improved with inhaled corticosteroid treatment. Conclusion. PLSVC is rare but can have important clinical implications. Associated severe cardiac malformations must be systematically sought.

Unexplained Hypoxemia in School-Age Child: Do Not Forget the Double Superior Vena Cava

“…Conversely, persistent left SVC with drainage in the left atrium can be related to relevant hemodynamic implications, allowing deoxygenated venous blood to bypass the lungs and return to the body [ 3 ]. Patients are usually school age children; they present increased risk of heart failure, intracerebral abscesses, disseminated infection and embolic cerebrovascular stroke [ 7 , 8 , 9 ]. Diagnosis could be done with echocardiography, but magnetic resonance (MR) imaging or low-dose CT with dedicated protocols are recommended to confirm the condition [ 8 ].…”

“…Patients are usually school age children; they present increased risk of heart failure, intracerebral abscesses, disseminated infection and embolic cerebrovascular stroke [ 7 , 8 , 9 ]. Diagnosis could be done with echocardiography, but magnetic resonance (MR) imaging or low-dose CT with dedicated protocols are recommended to confirm the condition [ 8 ]. Surgical or transcatheter correction should be performed in patients with large shunt or clinically relevant symptoms; additional congenital heart disease and cardiac rhythm disorder should also be investigated and excluded [ 4 , 7 ].…”