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Unique triad of shunts in a patient with paroxysmal palpitations!
  1. Nina Dhillon1 and
  2. Shravan Nosib2
  1. 1Internal Medicine, University of Saskatchewan College of Medicine, Saskatoon, Saskatchewan, Canada
  2. 2Cardiology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
  1. Correspondence to Dr Shravan Nosib; shravan.nosib{at}


We present the case of a 34-year-old woman with a rare constellation of congenital cardiovascular defects. She presented with new-onset dyspnoea on exertion and intermittent palpitations. Extensive cardiac workup revealed anomalous drainage of the inferior vena cava and a large secundum atrial septal defect. She underwent surgical repair. Intraoperatively, an additional congenital venous anomaly was discovered, a partial anomalous pulmonary venous connection. Specifically, the right inferior pulmonary vein connected to the inferior vena cava, and together, they drained into the left atrium. On conducting a thorough literature review, we believe this is the first reported case in an adult female.

  • cardiovascular medicine
  • heart failure

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  • Contributors ND was responsible for the literature review and writing of the manuscript. SN was involved in patient care and editing of the manuscript.

  • 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.

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