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Rare case of right ventricular dilatation associated with anomalous pulmonary venous drainage, sinus venosus atrial septal defect and persistent left superior vena cava
  1. Stephanie Rees1,
  2. Muhammad Tahir2,
  3. Syed Jawad Ahmad1 and
  4. Eduardas Subkovas2
  1. 1Acute Medicine, Betsi Cadwaladr University Health Board, Rhyl, UK
  2. 2Cardiology, Betsi Cadwaladr University Health Board, Rhyl, UK
  1. Correspondence to Dr Stephanie Rees; stephanie.rees4{at}wales.nhs.uk

Abstract

A 34-year-old woman was seen in the emergency department for shortness of breath and chest pain. During a pandemic, it is easy to ‘think horses and not zebras’, and with a patient presenting with the classic coronavirus symptoms it would have been easy to jump to that as her diagnosis. After a careful history and examination, it became clear that there was another underlying diagnosis. Chest X-ray, echocardiogram and CT scan revealed marked right ventricular dilatation and pulmonary hypertension, alongside a persistent left superior vena cava (PLSVC). Further investigation with cardiac MRI and coronary angiography at a tertiary centre demonstrated that she not only have a PLSVC but also a partial anomalous pulmonary venous drainage and sinus venosus atrial septal defect. This case highlights the importance of considering all differentials and approaching investigations in a logical manner.

  • cardiovascular medicine
  • congenital disorders

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Footnotes

  • Contributors SR, MT, SJA wrote the paper. ES was the supervising consultant. SR, MT, ES were involved in the patient’s care.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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