30 May 2020 : Case report
Educational Purpose (only if useful for a systematic review or synthesis), Rare coexistence of disease or pathologyBenjamin Mac Curtain12BDEF*, Roger Byrne2CD, Usama Boles2ABCDE
Am J Case Rep 2020; 21:e923633
BACKGROUND: The presentation of Brugada syndrome (BrS) with a persistent left superior vena cava (PLSVC) is expected to be a rare entity. It is unknown if this venous anomaly is linked to the arrhythmogenesis seen in BrS, or it is coincidental. This case describes a clinical presentation of the 2, in tandem, and displays the anomaly in association with BrS.
CASE REPORT: A 54-year-old female presented to the Emergency Department with non-prodromal syncope. This was on a background of a number of similar episodes in the past, and a current suspected viral illness comprising fever and diarrhea. Her resting electrocardiogram was suggestive of BrS. The later was confirmed with an ajmaline provocation test after ECG normalization in the subsequent 24 hours post admission. Pre-intracardiac defibrillator (ICD) procedure imaging displayed the PLSVC. An ICD was implanted, and the advancement of the guidewires displayed the venous anomaly. Post-procedure echocardiography confirmed appropriate positioning of the leads. The patient recovered well and is currently symptom free.
CONCLUSIONS: PLSVC presenting with BrS is a rare occurrence. It is unknown whether or not the PLSVC and BrS are linked in their presentation, or merely a coincidence.
Keywords: Arrhythmias, Cardiac, Brugada syndrome, Congenital Abnormalities, Death, Sudden, Cardiac, Comorbidity, Defibrillators, Implantable, Electrocardiography, Middle Aged, persistent left superior vena cava, Syncope, Vena Cava, Superior
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