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Musci RL, De Michele L, D'Agostino C, et al. Multifactorial Genesis of a Seeming Case of Pulmonary Hypertension. J Cardiovasc Echogr. 2017;27(4):149-152doi: 10.4103/jcecho.jcecho_34_17.
Musci, R. L., De Michele, L., D'Agostino, C., & Colonna, P. (2017). Multifactorial Genesis of a Seeming Case of Pulmonary Hypertension. Journal of cardiovascular echography, 27(4), 149-152. https://doi.org/10.4103/jcecho.jcecho_34_17
Musci, Rita Leonarda, et al. "Multifactorial Genesis of a Seeming Case of Pulmonary Hypertension." Journal of cardiovascular echography vol. 27,4 (2017): 149-152. doi: https://doi.org/10.4103/jcecho.jcecho_34_17
Musci RL, De Michele L, D'Agostino C, Colonna P. Multifactorial Genesis of a Seeming Case of Pulmonary Hypertension. J Cardiovasc Echogr. 2017 Oct-Dec;27(4):149-152. doi: 10.4103/jcecho.jcecho_34_17. PMID: 29142815; PMCID: PMC5672689.
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J Cardiovasc Echogr. 2017 Oct-Dec;27(4):149-152. doi: 10.4103/jcecho.jcecho_34_17.

Multifactorial Genesis of a Seeming Case of Pulmonary Hypertension.

Journal of cardiovascular echography

Rita Leonarda Musci, Lucrezia De Michele, Carlo D'Agostino, Paolo Colonna

Affiliations

  1. Cardiology Unit, University Hospital Policlinico, Bari, Italy.

PMID: 29142815 PMCID: PMC5672689 DOI: 10.4103/jcecho.jcecho_34_17

Abstract

Herein, we report the case of a 44-year-old female with end-stage renal disease on hemodialysis. She was admitted to our hospital to evaluate if she was eligible for a kidney transplant. Transthoracic echocardiography showed a markedly dilated coronary sinus and an unexpected finding of increased right ventriculoatrial gradient. A saline contrast echocardiography to confirm the presence of persistent left superior vena cava (PLSVC) was not performed because of arteriovenous fistula (FAV) for hemodialysis on the left forearm. Therefore, computed tomography angiography was performed, and it showed the PLSVC. We also proceeded with a transesophageal echocardiography which showed an atrial septal defect (ASD) of the sinus venous type hemodynamically significant. In this case, we identified a rare association of PLSVC with a ASD; therefore, there is a right ventricular volume overload because of the ASD hemodynamically significant and high flow FAV leading to a condition of a seeming pulmonary hypertension.

Keywords: Dilated coronary sinus; high-flow arteriovenous fistula; persistent left superior vena cava; sinus venous atrial septal defect

Conflict of interest statement

There are no conflicts of interest.

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