Persistent left superior vena cava (patient information)

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What is persistent left superior vena cava?

Persistent left superior vena cava (PLSVC) is a very rare and yet the most commonly described thoracic venous anomaly in medical literature. It has a 10-fold higher incidence with congenital heart disease. PLSVC often becomes apparent when an unknown PLSVC is incidentally discovered during central venous line placement, intracardiac electrode/pacemaker placement or cardiopulmonary bypass, where it may cause technical difficulties and life-threatening complications. PLSVC is also associated with disturbances of cardiac impulse formation and conduction including varying degrees of heart blocks, supraventricular arrhythmias and Wolff Parkinson White syndrome. We describe the case of an 86-year-old male with a history of coronary artery disease and chronic atrial fibrillation who presented with worsening dyspnea and syncopal episodes. An ECG was consistent with complete heart block. During lead placement for the pacemaker, a left subclavian approach was unsuccessful. A left venogram was performed through the brachial vein that demonstrated a left superior vena cava. The diagnosis was confirmed with echocardiography using a bubble study and also a chest CT. The anatomy was unique as there was anomalous left hepatic vein drainage into the right atrium. The case provides insight into the diagnostic modalities and clinical considerations of this unusual thoracic venous anomaly.

How do I know if I have persistent left superior vena cava and what are the symptoms of persistent left superior vena cava?

The signs and symptoms depends on where the left superior vena cava flows to. If it finally flows to right atria, patients may have no sign or aymptom. But if the left superior vena cava flows to flows to left atria, symptoms may include anoxemia, such as fatigue, weakness, dizziness and shortness of breath.

Who is at risk for persistent left superior vena cava?

The cause of persistent left superior vena cava is not clear.

How to know you have persistent left superior vena cava?

• Echocardiography: This kind of painless test can help the doctor closely examine persistent left superior vena cava. It uses sound waves to produce an image of the ventricles, atrium and great vessles. Echocardiogram can tell whether left superior vena cava flows to right areia or not. Further more, the doctor can measure the speed of blood flow by echocardiogram.
• Chest x-ray: An x-ray image of chest allows the doctor to check the size and shape of your great vessles and heart.
• Chest CT or MRI: A chest CT or MRI can demonstrate the details of the heart extremely well, such as the great vessles, vascular, atrial and ventricular structures and their relationships to one another.
• Cardiac catheterization: This is not a common diagnostic measure for persistent left superior vena cava. In a catheter room, the doctor threads a thin tube through a blood vessel in the patient's arm or groin to an artery in the heart and injects dye to see great vessles, atria and ventricles on an x-ray. Cardiac catheterization can reveal associated cardiac abnormalities are known or suspected.

When to seek urgent medical care?

Call your health care provider if your baby has symptoms of persistent left superior vena cava. If one emerges the following symptoms, seeking urgent medical care as soon as possible:

• Shortness of breath

Diseases with similar symptoms

• Ventricular septal defect
• Atrioventricular septal defect

Where to find medical care for persistent left superior vena cava?

Directions to Hospitals Treating persistent left superior vena cava

Prevention of persistent left superior vena cava

The preventive measure of persistent left superior vena cava is unknown.

What to expect (Outook/Prognosis)?

Prognosis of persistent left superior vena cava depends on where the left superior vena cava flows to and. The prognosis of left superior vena cava flows to left atria is worse than that flows to the right atria.

Copyleft Sources

http://www.medscape.com/viewarticle/455713

http://smj.sma.org.sg/4803/4803cr7.pdf