Weariness and increased d...

A 60-year-old man experiencing considerable weariness and increased dyspnea for a year came in for a consultation. Hypoxemia and bilateral crackles were found throughout the examination. Blood and ECG tests revealed nothing unusual. An X-ray of the chest showed reticular marks. An isolated persistent left superior vena cava (PLSVC) and abnormalities associated with pulmonary fibrosis were found on a contrast-enhanced chest C.T. (figure 1A–B). A single PLSVC can be seen in the chest C.T. picture flowing over the left mediastinum and draining into the right atrium through the coronary sinus (figure 1B). The anatomy and configuration of the vascular variation are shown in a three-dimensional reconstruction with volume rendering (figure 2).