Presentation
Shortness of breath.
Patient Data
No pulmonary embolism, mildly dilated ascending aorta. A left superior vena cava drains into the coronary sinus, absent right superior vena cava.
Case Discussion
There are three main possible explanations if there is a vessel to the left of the aortic arch. A vessel formed by either the left brachiocephalic vein alone or both brachiocephalic veins that drains inferiorly into the coronary sinus is a left superior vena cava. If the vessel connects the left brachiocephalic vein to the Hemi-azygos vein, the vessel is a left superior intercostal vein. If the vessel arises from the left upper lobe pulmonary veins and drains into the left brachiocephalic vein but has no connection to the Hemi-azygos vein, the patient has partial anomalous pulmonary venous return.
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