Key result
A 78-year-old woman with an ischemic stroke was diagnosed with a rare persistent left superior vena cava draining into the left atrium via the pulmonary vein, predisposing her to paradoxical embolism.
Case Report (n=1)
This case highlights the importance of careful agitated saline contrast echocardiography, particularly using left arm injection, to diagnose rare causes of paradoxical embolism such as PLSVC draining into the left atrium.
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May suggest PLSVC as rare embolic source in cryptogenic stroke; hypothesis-generating and requires larger prospective validation.
Cardiogenic embolic stroke accounts for approximately 20% of ischemic strokes and the likelihood of its recurrence is high.Paradoxical embolism may be an important cause of cardioembolic stroke, which can be evaluated through multiple diagnostic modalities including transesophageal echocardiography (TTE) or transcranial Doppler.A persistent left superior vena cava (PLSVC) is a rare congenital vascular anomaly, which mainly drains to the right atrium via the coronary sinus.Although rare, PLSVC draining into the left heart predisposes the patient to paradoxical embolism through a right-to-left shunt.We report on a 78year-old female patient with an ischemic stroke associated with PLSVC draining into the left atrium through the pulmonary vein, which was investigated via TTE with an agitated saline test and computed tomography.
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Kwon et al. (2015) conducted a case report in Ischemic stroke associated with persistent left superior vena cava (n=1). Persistent left superior vena cava (PLSVC) draining into the left atrium was evaluated on Diagnosis of paradoxical embolism source. A 78-year-old woman with an ischemic stroke was diagnosed with a rare persistent left superior vena cava draining into the left atrium via the pulmonary vein, predisposing her to paradoxical embolism.
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