International Medical Case Reports Journal (Jul 2025)

Late Presentation of Isolated Persistent Left Superior Vena Cava with Absent Right Superior Vena Cava Manifesting as Heart Failure: A Case Report

  • Ahmed SA,
  • Dahir OF,
  • Abdi AE,
  • Adan AS,
  • Abdi IA,
  • Waberi MM,
  • Mohamud MA,
  • Fujeyra AMH,
  • Ali AA,
  • Ahmed MA,
  • Adan Ali BA,
  • Hassan MS,
  • Aksu F,
  • Mukhtar MS,
  • Ibrahim IG,
  • Hassan MO

Journal volume & issue
Vol. Volume 18, no. Issue 1
pp. 811 – 816

Abstract

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Said Abdirahman Ahmed,1 Osman Farah Dahir,1 Ahmed Elmi Abdi,1 Ahmed Shafie Adan,1 Ishak Ahmed Abdi,1 Mohamud Mire Waberi,1 Mohamed Abdullahi Mohamud,2 Abdullahi Mohamed Hassan Fujeyra,3,4 Abdijalil Abdullahi Ali,5 Mohammed AM Ahmed,6,7 Bakar Ali Adan Ali,8 Mohamed Sheikh Hassan,8 Feyza Aksu,1 Mahad Sadik Mukhtar,9 Ismail Gedi Ibrahim,10 Mohamed Omar Hassan1 1Department of Cardiology at Mogadishu Somali-Turkish Training and Research Hospital, Mogadishu, Somalia; 2Department of Cardiology at Jazeera Specialist Hospital, Mogadishu, Somalia; 3College of Medicine and Health Science, Abrar University, Mogadishu, Somalia; 4Faculty of Medicine & Surgery, Somali National University, Mogadishu, Somalia; 5Cardiovascular Surgery Department at Mogadishu Somali-Turkish Training and Research Hospital, Mogadishu, Somalia; 6Faculty of medicine, Mogadishu University, Mogadishu, Somalia; 7Department of Pediatric Cardiology, Mogadishu Heart Center, Mogadishu, Somalia; 8Neurology Department at Mogadishu Somali-Turkish Training and Research Hospital, Mogadishu, Somalia; 9Pulmonology Department at Mogadishu Somali-Turkish Training and Research Hospital, Mogadishu, Somalia; 10Department of Radiology, at Mogadishu Somali-Turkish Training and Research Hospital, Mogadishu, SomaliaCorrespondence: Osman Farah Dahir, Mogadishu Somalia Turkish Training and Research Hospital, Digfer Road, Mogadishu, Somalia, Tel +252615963164, Email [email protected]: Persistent left superior vena cava (PLSVC) with absent right superior vena cava (RSVC) is a rare congenital venous anomaly, typically asymptomatic and discovered incidentally. In rare cases, it may contribute to hemodynamic disturbances and arrhythmias, potentially leading to heart failure, especially when associated with other cardiac anomalies or conduction abnormalities.Case Presentation: We report the case of a 45-year-old male who presented with progressive symptoms of heart failure, including dyspnea, fatigue, and reduced exercise tolerance. Initial workup revealed an unexplained dilated coronary sinus and reduced left ventricular function with dilated heart chambers. Further imaging with contrast-enhanced echocardiography and CT angiography confirmed the presence of a PLSVC draining into the coronary sinus with absence of right superior vena cava. No other congenital heart defects were identified like coronary sinus atrial septal defect (ASD). The delayed diagnosis of PLSVC likely contributed to chronic atrial stretch, arrhythmia development- atrial fibrillation in this case, and eventual heart failure symptoms.Conclusion: This case highlights the importance of considering vascular anomalies like PLSVC in the differential diagnosis of unexplained heart failure or dilated coronary sinus. Early detection through appropriate imaging can guide management and potentially prevent progression of symptoms.Keywords: persistent left superior vena cava, PLSVC, echocardiography, atrial fibrillation, heart failure

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