Persistent both superior vena cava (SVC) with subaortic membrane: A case report

A persistent left superior vena cava (PLSVC) is seen rare but it is the most common thoracic venous anomaly .We report a 30-year-old male presented by repeated attacks of exertional chest pain over the past 2 months that were precipitated by moderate exertion and last for few minutes and relieved by rest. Echocardiography showed an evidence of subaortic flow turbulence with a visible subaortic membrane and mild aortic regurgitation . The Aortic valve was trileaflet with normal leaflets thickness and excursion . Contrast echocardiography using agitated saline injection in the left antecubital vein showed an opacification of the coronary sinus before the right ventricular outflow tract. Non-invasive transthoracic echocardiography study by agitated saline contrast can be easily performed to confirm the related venous anomaly. Computed tomography (CT) of the chest with contrast confirmed the persistence of both right and left SVCs and then, The patient was reassured with symptomatic therapy and he was requested a regular follow up in outpatient clinic. Thus, most adult patients with PLSVC and subaortic membrane should be reassured by symptomatic management.