Left Superior Vena Cava

Imaging studies

Comments

Persistent left superior vena cava (LSVC) is usually an incidental finding during echocardiography, cardiothoracic surgery or autopsy. Echocardiographic findings of LSVC include dilation of the coronary sinus in absence of right atrial enlargement and increased right atrial pressures. The dilated coronary sinus can protrude into the left atrium, sometimes being mistaken for a left atrial mass. The diagnosis is definitively confirmed by contrast echocardiography. With injection of agitated saline or contrast in a left arm vein, contrast should first appear in the coronary sinus, followed by opacification of the right atrium. Injection of echo contrast into a right arm vein should opacify the right atrium but not the coronary sinus.

Clinical considerations...