Superior Vena Cava Anomalies in the Generation of Angina Pectoris

Abstract

Superior vena cava anomalies are rare occurrences caused by variations in the development of the embryonic venous system. Persistent left superior vena cavae are the most common congenital aberrations in the thoracic venous system, with an incidence of 0.3–0.5%, but their association in the absence of a right superior vena cava is extremely rare and scarcely reported. We report two case studies describing persistent left superior vena cavae found with and without a right superior vena cava in patients presenting with chest pain. A discussion regarding superior vena cava abnormalities as well as the etiology, associations, and diagnosis of these unusual entities follows.

Persistent left superior vena cava with an absent right superior vena cava in a 72-year-old male with multivessel coronary artery disease

“…Due to the abnormal path of the electrode, there can be a problem in obtaining a stable electrode position. Also, incidental access to the coronary sinus may cause hypotension, chest pain, perforation of the heart, tamponade and cardiac arrest [1,6,13,16]. Moreover, P wave abnormalities due to right atrial and ventricular enlargement, and arrhythmias due to stretching of the atrioventricular node and bundle of His may be observed on an ECG [19].…”

Giant coronary sinus and a review of the literature

“…Significant coronary sinus dilatation may lead to obstruction of the left ventricular inflow tract, causing an imbalance between myocardial blood flow and increased oxygen demand from physical exertion and, also, the mitral valve may be partially occluded, causing symptoms [6]. This is a very rare case with a very large giant coronary sinus with persistent left superior caval vein diagnosed during a patient's chest pain.…”