TY - JOUR T1 - Multiple thromboembolic events associated with bilateral superior vena cava and anomalous drainage into the left atrium JF - BMJ Case Reports JO - BMJ Case Reports DO - 10.1136/bcr-2020-237401 VL - 14 IS - 2 SP - e237401 AU - Maria Elizabeth Karavassilis AU - Michael Haji-Coll AU - Niall G Keenan Y1 - 2021/02/01 UR - http://casereports.bmj.com/content/14/2/e237401.abstract N2 - A 49-year-old female patient presented with acute-on-chronic chest pain. She was diagnosed with multiple systemic thromboemboli, including myocardial infarctions, bilateral chronic pulmonary emboli, ischaemic stroke, deep venous thrombosis and superficial thrombophlebitis. She had a background of sickle cell trait. Cardiac magnetic resonance showed bilateral superior vena cava (SVC). The right-sided SVC (RSVC) was joined by the right upper pulmonary vein and drained anomalously into the left atrium. This caused a small volume right to left shunt. The persistent left SVC drained into the right atrium (RA) via a dilated coronary sinus. The overall clinical impression was recurrent paradoxical emboli due to anomalous venous anatomy with a thrombophilia secondary to sickle cell trait. In the normal embryo, the right common cardinal vein develops to become the RSVC, which drains into the RA by term. ER -