Ginormous Coronary Sinus with Persistent Left Superior Vena Cava

An echocardiogram is the most common diagnostic imaging done in chest pain evaluation workup. Persistent left superior vena cava is a rare thoracic congenital anomaly but commonly reported one in the literature. Dilated coronary sinus on echocardiogram is a signal to think of persistent left superior vena cava which can be presented with atypical chest pain and palpitation but is often asymptomatic. As a catheter from left subclavian approach can incidentally advance to the right side of the heart, early awareness of PLSVC is crucial to prevent unwanted procedure related complications.