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Scimitar syndrome (CMR)

Case contributed by David Cuevas
Diagnosis certain

Presentation

Exertional dyspnea.

Patient Data

Age: 45 years
Gender: Female
x-ray
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Info

Cardiomegaly, likely due to right chambers enlargment. 

Tubular opacity in the lower lobe of the right lung.

mri
This study is a stack
Axial
TRUFI
This study is a stack
Custom view of the
scimitar vein SSFP
This study is a stack
Custom view PV
and LA SSFP
This study is a stack
Four chamber
view SSFP
This study is a stack
Three chambers view
Three chamber view SSFP
This study is a stack
Right two
chambers SSFP
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Info

Mild decrease in right lung volume with mild shift of the heart to the right. 

Enlargement of right cardiac chambers is confirmed.

Cine images demonstrating the main scimitar vein draining into inferior vena cava

ct
This study is a stack
Axial C+
arterial phase
Frontal view 3D
C+ arterial phase
Posterior view 3D
C+ arterial phase
Fontal view of 3D angiogram
overlapped on x ray C+ arterial phase
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Info

Scimitar vein draining into inferior vena cava

Mild shift of the heart to the midline due to hypoplasic lung.

CT contributed by Dr Lazaro Delgado

Case Discussion

Classic example of Scimitar syndrome. Cine images accurately illustrate the connection of the scimitar vein.

Patients can be asymptomatic when <50% of the pulmonary circulation or remain subclinical, such as this case.

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