Left sided superior vena cava

Case contributed by Daniel Hyeong Seok Kim

Presentation

Past medical history significant for B cell lymphoma with known mass presenting with chest pain and presyncope.

Patient Data

Age: 55 years
Gender: Female
x_ray

The left upper extremity peripherally inserted central catheter coursing through the persistent left sided superior vena cava terminates in the region of the distal superior vena cava.

No discrete focal pneumonia, effusion or pneumothorax.

Mild prominence of the aortic knob.

The heart and central pulmonary vascularity are normal.

No acute osseous findings. The upper abdomen appears normal.

Case Discussion

Most patients with persistent left sided superior vena cava remains asymptomatic, it is usually discovered incidentally upon chest imaging. During embryogenesis, the presence of the left anterior cardinal vein and obliteration of the left common cardinal vein leads to the formation of the left superior vena cava. The persistent left sided superior vena cava usually drains into the right atrium (in 80–90%) through a dilated coronary sinus, but in approximately 10 to 20% of cases, it is associated with left atrial drainage.

 

This case was submitted with supervision and input from:
Soni C. Chawla, M.D.
Health Sciences Clinical Professor,
Department of Radiological Sciences,
David Geffen School of Medicine at UCLA.
Attending Radiologist,
Olive View - UCLA Medical Center.

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