title: Hypoxia caused by persistent left superior vena cava connecting to the left atrium a rare clinical entity.
abstract: We relate the case of a 40-year-old man with a history of premature birth and dextroposition of the heart who presented for an evaluation of persistent hypoxia. An unrevealing pulmonary evaluation and agitated-saline echocardiogram led to cardiac magnetic resonance imaging. This revealed a very unusual finding: a persistent left superior vena cava with insertion into the left atrium and a small connecting vein between the right and left superior venae cavae. The implications, embryology, and pathogenesis of this rare condition are discussed.
authors.affiliation: Department of Medicine, Division of Cardiology, National Jewish Health, Denver, Colorado 80207, USA. freemana@njhealth.org
authors.forename: Andrew M
authors.initials: AM
authors.lastname: Freeman
authors.forename: Brett E
authors.initials: BE
authors.lastname: Fenster
authors.forename: Howard D
authors.initials: HD
authors.lastname: Weinberger
authors.forename: J Kern
authors.initials: JK
authors.lastname: Buckner
authors.forename: David
authors.initials: D
authors.lastname: Lynch
mesh_terms: D000328:Adult; D003914:Dextrocardia / Q000150:complications; D004452:Echocardiography / Q000379:methods; D004562:Electrocardiography; D006325:Heart Atria / Q000002:abnormalities; D006330:Heart Defects, Congenital / Q000150:complications* / Q000175:diagnosis; D006801:Humans; D000860:Hypoxia / Q000209:etiology*; D008279:Magnetic Resonance Imaging; D008297:Male; D011237:Predictive Value of Tests; D047928:Premature Birth; D012965:Sodium Chloride; D014057:Tomography, X-Ray Computed; D014683:Vena Cava, Superior / Q000002:abnormalities*
chemical_list: D012965:Sodium Chloride
keywords: Coronary vessel abnormalities/diagnosis; embryology; heart atria/abnormalities; heart defects, congenital/diagnosis; hypoxia; magnetic resonance imaging; middle aged; vena cava, superior/abnormalities