Persistent Left Superior Vena Cava (PLSVC): Case Report

Dr Arulanandhan Ettiyan, Dr. Sureshkumar Ponnuswamy

Abstract: This clinical case captures the nuanced presentation of a rare vascular anomaly-Persistent Left Superior Vena Cava (PLSVC)-in a 35-year-old female who reported progressive breathlessness and chest discomfort. What initially appeared to be a straightforward cardiac complaint gradually unraveled into a more layered diagnosis through a series of well-integrated imaging findings. It is evident that the presence of a dilated coronary sinus, often an overlooked detail, served as a subtle clue pointing toward PLSVC. Interestingly, despite normal left ventricular function, signs of right-sided pressure overload-including a D-shaped left ventricle, moderate pulmonary hypertension, and a dilated pulmonary artery-revealed the deeper hemodynamic consequences of the underlying anomaly. The identification of a secundum atrial septal defect (ASD) with left-to-right shunting further complicated the picture, suggesting a congenital interplay that may have gone unnoticed without detailed echocardiographic and CT angiographic correlation. This raises an important consideration: in patients with unexplained right heart dilation and a conspicuously enlarged coronary sinus, the possibility of PLSVC should not be dismissed. Taking this further, the case highlights the diagnostic value of combining transthoracic and transesophageal echocardiography with cross-sectional imaging, not just to confirm vascular anomalies but to understand their functional impact on cardiac morphology and pressures. Ultimately, this report reinforces the teaching that seemingly incidental findings can serve as diagnostic turning points when interpreted in the right clinical context.

Keywords: Persistent Left Superior Vena Cava, Atrial Septal Defect, Pulmonary Hypertension, Coronary Sinus Dilation, Right Heart Overload

How to Cite?: Dr Arulanandhan Ettiyan, Dr. Sureshkumar Ponnuswamy, "Persistent Left Superior Vena Cava (PLSVC): Case Report", Volume 14 Issue 8, August 2025, International Journal of Science and Research (IJSR), Pages: 189-190, https://www.ijsr.net/getabstract.php?paperid=SR25731182809, DOI: https://dx.doi.org/10.21275/SR25731182809