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Filomena D, Monosilio S, Sannino M, Cimino S, Maestrini V, Bruno E, Miraldi F, Fedele F, Vizza CD, Agati L. Complex connections: A young man presenting with shortness of breath, hypoxemia, right lumbar pain and left limb swelling. Echocardiography 2022; 39:631-636. [PMID: 35253264 PMCID: PMC9314040 DOI: 10.1111/echo.15330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 01/17/2022] [Accepted: 02/09/2022] [Indexed: 12/02/2022] Open
Abstract
A 43‐year‐old Caucasian man was admitted to hospital due to shortness of breath, right lumbar pain and lower left limb swelling. Arterial blood gas sample showed mild hypoxemia and respiratory alkalosis. CT scan confirmed pulmonary embolism, splenic and bilateral renal ischemic lesions. Echocardiography showed right ventricular and coronary sinus (CS) dilatation. Using contrast echocardiography, a superior sinus venous atrial septal defect and persistent left superior vena cava (PLSVC) draining in CS were suspected. Cardiac CT confirmed the diagnosis and showed overriding right superior vena cava (RSVC) draining in both atria. The patient underwent successful surgical correction.
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Affiliation(s)
- Domenico Filomena
- Department of Clinical, Internal, Anesthesiologic and Cardiovascular Sciences "Sapienza", University of Rome, Policlinico Umberto I, Rome, Italy
| | - Sara Monosilio
- Department of Clinical, Internal, Anesthesiologic and Cardiovascular Sciences "Sapienza", University of Rome, Policlinico Umberto I, Rome, Italy
| | - Michele Sannino
- Department of Clinical, Internal, Anesthesiologic and Cardiovascular Sciences "Sapienza", University of Rome, Policlinico Umberto I, Rome, Italy
| | - Sara Cimino
- Department of Clinical, Internal, Anesthesiologic and Cardiovascular Sciences "Sapienza", University of Rome, Policlinico Umberto I, Rome, Italy
| | - Viviana Maestrini
- Department of Clinical, Internal, Anesthesiologic and Cardiovascular Sciences "Sapienza", University of Rome, Policlinico Umberto I, Rome, Italy
| | - Emanuele Bruno
- Department of Clinical, Internal, Anesthesiologic and Cardiovascular Sciences "Sapienza", University of Rome, Policlinico Umberto I, Rome, Italy
| | - Fabio Miraldi
- Department of Clinical, Internal, Anesthesiologic and Cardiovascular Sciences "Sapienza", University of Rome, Policlinico Umberto I, Rome, Italy
| | - Francesco Fedele
- Department of Clinical, Internal, Anesthesiologic and Cardiovascular Sciences "Sapienza", University of Rome, Policlinico Umberto I, Rome, Italy
| | - Carmine Dario Vizza
- Department of Clinical, Internal, Anesthesiologic and Cardiovascular Sciences "Sapienza", University of Rome, Policlinico Umberto I, Rome, Italy
| | - Luciano Agati
- Department of Clinical, Internal, Anesthesiologic and Cardiovascular Sciences "Sapienza", University of Rome, Policlinico Umberto I, Rome, Italy
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