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Yeungnam Univ J Med > Volume 32(2); 2015 > Article
Yeungnam University Journal of Medicine 2015;32(2):118-121.
DOI: https://doi.org/10.12701/yujm.2015.32.2.118    Published online December 31, 2015.
Unusual paradoxical embolic stroke in a patient with persistent left superior vena cava.
Tae Hun Kwon, Kang Un Choi, Byung Jun Kim, Jae Ho Cho, Jae Young Lee, Kyu Hwan Park, Sang Hee Lee, Jang Won Son
Division of Cardiology, College of Medicine, Yeungnam University, Daegu, Korea. gubjae@hanmail.net
Abstract
Cardiogenic embolic stroke accounts for approximately 20% of ischemic strokes and the likelihood of its recurrence is high. Paradoxical embolism may be an important cause of cardioembolic stroke, which can be evaluated through multiple diagnostic modalities including transesophageal echocardiography (TTE) or transcranial Doppler. A persistent left superior vena cava (PLSVC) is a rare congenital vascular anomaly, which mainly drains to the right atrium via the coronary sinus. Although rare, PLSVC draining into the left heart predisposes the patient to paradoxical embolism through a right-to-left shunt. We report on a 78-year-old female patient with an ischemic stroke associated with PLSVC draining into the left atrium through the pulmonary vein, which was investigated via TTE with an agitated saline test and computed tomography.
Key Words: Persistent left superior vena cava, Stroke, Paradoxical embolism
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