ANOMALOUS DRAINAGE OF THE RIGHT SUPERIOR VENA-CAVA INTO THE LEFT ATRIUM IN A 61-YEAR-OLD WOMAN

This report describes a 61-year-old female with an anomalous drainage of the right superior vena cava into the left atrium. The patient pres ented progressively severe dyspnea and precordial pain on exertion, li ghtheadedness, easy fatiguability and a constant decline in her perfor mance but normal cardiac and pulmonary findings. Following a suspiciou s lung perfusion scan, diagnosis was assessed by echocardiography and confirmed by cardiac catheterization and nuclear magnetic resonance im aging. This anomaly leading to a right to left shunt appears to be a r are congenital cardiac malformation, particularly if diagnosed in the adult. The calculated shunt volume at rest was approximately 15% of th e total body circulation. Although the functional relevance appears qu estionable, exercise of the upper limbs caused a significant decrease in systemic O-2-saturation. (C) 1998 Elsevier Science Ireland Ltd.