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A 76-year-old man presented with acute breathlessness, cyanosis (oxygen saturation 75%), and biventricular failure. Left and right heart catheterization confirmed an occluded right coronary artery and raised right atrial (RA) pressure (17 mmHg). To exclude pulmonary embolus, computed tomography pulmonary angiogram (CTPA) with contrast injected into the left arm revealed persistent left superior vena cava (LSVC) draining not as expected into the RA via …

european heart journal

Persistent left superior vena cava draining into the left atrium: an elderly man with hypoxia, cyanosis, and paradoxical shunting post-myocardial infarction