Partial Anomalous Pulmonary Venous Return to the Superior Vena Cava, a Rare but Classic Diagnosis

Partial anomalous pulmonary venous return (PAPVR) is a rare congenital anomaly in which one or more pulmonary veins incorrectly drains into the systemic venous system, typically the superior vena cava. This results in a left-to-right shunt, possibly leading to pulmonary artery hypertension (PAH) and right heart failure. PAPVR can present in adulthood with nonspecific symptoms and may be misdiagnosed as primary PAH. Early identification allows close monitoring and/or surgical correction, potentially preventing progression to severe PAH and heart failure, making this a diagnosis not to be missed. We present a case of an 85-year-old man with heart failure and tricuspid valve insufficiency who underwent a contrast-enhanced CT scan to rule out pulmonary embolism that instead revealed PAPVR, with the right superior pulmonary vein draining into the superior vena cava.