Double superior vena cava
Breathlessness on exertion. Pregnant. History of breast cancer. ? PE
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IV contrast has been administered via the left arm.
There is excellent contrast opacification of the pulmonary arterial vasculature. No pulmonary artery filling defect is identified. No signs of right heart strain are evident.
There is an incidental double SVC, with the left SVC draining into the coronary sinus which is mildly dilated.
Small pericardial effusion but there is no obvious pericardial thickening. No hilar or mediastinal lymphadenopathy. Moderate sized hiatus hernia. The lungs are clear. No pleural effusion.
The upper abdominal viscera are unremarkable. No focal bone abnormality.
The double SVC arises when there is failure of of the embryonic left anterior cardiac vein to regress. Drainage is variable and can be to:
- right atrium: via oblique vein of Marshall
- coronary sinus
- left atrium