Left-sided partial anomalous pulmonary venous return in a septuagenarian

摘要

Computed tomography in a 78-year-old woman with suspected pulmonary embolism showed dilated right cardiac chambers with no signs of pulmonary embolism (Figure 1), and incidentally discovered isolated left-sided partial anomalous pulmonary venous return with the left upper pulmonary veins draining via a vertical vein into the innominate vein (Figure 2). Transthoracic echocardiography showed dilated right chambers and a moderate tricuspid regurgitation jet gradient of 45 mm Hg, suggestive of moderate pulmonary hypertension. Cases of partial anomalous pulmonary venous return are rare (incidence <1%), less than 10% are left-sided, and up to 80% have associated atrial septal defects. If left untreated, long-standing partial anomalous pulmonary venous return predisposes to right-sided volume overload, tricuspid regurgitation, and finally, right ventricular failure.