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KMID : 1100320150320020118
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Yeungnam University Journal of Medicine
2015 Volume.32 No. 2 p.118 ~ p.121
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Unusual paradoxical embolic stroke in a patient with persistent left superior vena cava
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Kwon Tae-Hun
Choi Kang-Un
Kim Byung-Jun
Cho Jae-Ho
Lee Jae-Young
Park Kyu-Hwan
Lee Sang-Hee
Sohn Jang-Won
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Abstract
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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.
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KEYWORD
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Persistent left superior vena cava, Stroke, Paradoxical embolism
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