Answer for BIR CoW 13 Jan 2019
Left sided SVC
Findings
Left superior vena cava noted draining into dilated coronary sinus which drains into right atrium. Coronary sinus measures 14.2 mm. Right superior vena cava appears small. Left upper pulmonary veins are seen normally draining into left atrium. There is arterio ventricular & veno atrial concordance. IMPRESSION : Persistent left superior vena cava draining into right atrium through prominent coronary sinus. Small right superior vena cava. No Evidence of anomalous pulmonary venous drainage.
Discussion
Left Sided Superior Vena Cava Is The Most Common Venous Anomaly Detected In The Chest . Left Sided Superior Vena Cava forms when the anterior cardinal vein fails to obliterate during normal fetal development . The persistent left sided Superior vena cava passes anterior to the left hilum and lateral to the aortic arch before joining the circulatopry system . The possible drainage sites are : Coronary sinus (92%) – functionally insignificant since venous return from head, neck , and upper limbs is delivered to the right atrium. Left atrium (8%) – results in a right to left shunt which is usually not large enough to cause cyanosis / symptoms . In the vast majority of cases (82 – 90 %) a normal (but small) right sided Superior vena cava is also present,and a persistent bridging vein ( left BCV) is seen in 25-35% of the cases.
Findings
Left superior vena cava noted draining into dilated coronary sinus which drains into right atrium. Coronary sinus measures 14.2 mm. Right superior vena cava appears small. Left upper pulmonary veins are seen normally draining into left atrium. There is arterio ventricular & veno atrial concordance. IMPRESSION : Persistent left superior vena cava draining into right atrium through prominent coronary sinus. Small right superior vena cava. No Evidence of anomalous pulmonary venous drainage.
Discussion
Left Sided Superior Vena Cava Is The Most Common Venous Anomaly Detected In The Chest . Left Sided Superior Vena Cava forms when the anterior cardinal vein fails to obliterate during normal fetal development . The persistent left sided Superior vena cava passes anterior to the left hilum and lateral to the aortic arch before joining the circulatopry system . The possible drainage sites are : Coronary sinus (92%) – functionally insignificant since venous return from head, neck , and upper limbs is delivered to the right atrium. Left atrium (8%) – results in a right to left shunt which is usually not large enough to cause cyanosis / symptoms . In the vast majority of cases (82 – 90 %) a normal (but small) right sided Superior vena cava is also present,and a persistent bridging vein ( left BCV) is seen in 25-35% of the cases.
Note:
We do not discourage differential diagnosis. But all the differentials must satisfy the findings noted in the case.
If you feel you have answered rightly but cannot find your name in the above list, please call 09551942599.
Did you Know?
The order in which the names appear in this winner's list is based on the time of submission. The first person to send the correct answer gets his/her name on top of the list!
We do not discourage differential diagnosis. But all the differentials must satisfy the findings noted in the case.
If you feel you have answered rightly but cannot find your name in the above list, please call 09551942599.
Did you Know?
The order in which the names appear in this winner's list is based on the time of submission. The first person to send the correct answer gets his/her name on top of the list!