Scimitar Syndrome

A 56-year-old woman who underwent secundum atrial septal defect closure at the age of 25 years was referred to the Mayo Clinic for exertional dyspnea and symptomatic atrial fibrillation. On examination, she was acyanotic, with an irregularly irregular heart rate of 86 beats per minute and a blood pressure of 140/80 mm Hg. She had a fixed S2 split with a normal apical impulse.During the course of her work-up, transthoracic echocardiography demonstrated anomalous pulmonary venous return of the right upper and lower pulmonary veins to the inferior vena cava just above the diaphragm (Scimitar syndrome). The …