Presentation
Acute shortness of breath and pleuritic chest pain. Past history of breast cancer.
Patient Data
The right internal thoracic (mammary) vein is seen draining directly into the superior vena cava.
Case Discussion
The internal thoracic (mammary) veins are venae comitantes of each internal thoracic artery draining the territory supplied by it and usually unite opposite the third costal cartilage. These veins usually drain into the ipsilateral brachiocephalic veins.
Right thoracic vein draining directly to superior vena cava (SVC) is a very rare normal variant.
Knowledge of the internal thoracic vessel anatomy is important to avoid hemorrhagic complications when an anterior parasternal approach is used for various procedures but also to avoid complications of central venous catheter insertion.