Abstract
A persistent left superior vena cava (PLSVC) is seen rare but it is the
most common thoracic venous anomaly .We report a 30-year-old male
presented by repeated attacks of exertional chest pain over the past 2
months that were precipitated by moderate exertion and last for few
minutes and relieved by rest. Echocardiography showed an evidence of
subaortic flow turbulence with a visible subaortic membrane and mild
aortic regurgitation . The Aortic valve was trileaflet with normal
leaflets thickness and excursion . Contrast echocardiography using
agitated saline injection in the left antecubital vein showed an
opacification of the coronary sinus before the right ventricular outflow
tract. Non-invasive transthoracic echocardiography study by agitated
saline contrast can be easily performed to confirm the related venous
anomaly. Computed tomography (CT) of the chest with contrast confirmed
the persistence of both right and left SVCs and then, The patient was
reassured with symptomatic therapy and he was requested a regular follow
up in outpatient clinic. Thus, most adult patients with PLSVC and
subaortic membrane should be reassured by symptomatic management.