Double superior vena cava

Case contributed by Dr Craig Hacking

Presentation

Breathlessness on exertion. Pregnant. History of breast cancer. ? PE

Patient Data

Age: 40-45 years
Gender: Female
CT

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.

Case Discussion

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
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Case information

rID: 34685
Case created: 5th Mar 2015
Last edited: 18th Aug 2017
Systems: Vascular, Chest
Inclusion in quiz mode: Included

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