Background: Anomalous systemic venous connection with
the left atrium per se is a very rare cause of desaturation.The
purpose of presenting this particular case is to make
emphasis on evaluating the patients with isolated cyanosis
meticulously. We have tried to review the previously
reported cases of such anomaly under the discussion part.
Case presentation: 24-years-old young healthy lady
developed symptoms of mild respiratory infection and
had gone to a nearby physician Echocardiography
showed that heart chambers, ejection fraction, and
pulmonary artery pressure were normal. She underwent
further evaluation with an HRCT and echocardiogram
because of unexplained persistent desaturation. Her
HRCT revealed no parenchymal lung changes which
could explain desaturation. On Echocardiography, right
SVC to left atrium was suspected. Chest Computed
Tomography (CT) obtained after contrast material
injection into the right arm vein confirmed the large right
sided superior vena cava (SVC) and a small persistent left
SVC draining into left atrium (LA) which explained low
saturation being a significant right-to-left shunt caused by
the right-sided superior vena cava (SVC) draining into the
left atrium Eventually patient was referred to surgery.
Conclusions: Patient who has unexplained desaturation
on clinical examination should be looked with suspicion of
having anomalous systemic venous drainage. In these
suspected cases of RSVC into the LA, cardiac
catheterization should be performed to rule out other
intracardiac lesions and to evaluate pulmonary venous
drainage, and right ventricular size if there are no other
definite contraindications to use contrast.
Keywords : Partial anomalous systemic venous drainage, Cyanosis, Left atrium.