Point-of-Care Ultrasound to Detect Dilated Coronary Sinus in Adults

Zouheir I Bitar 1, Mohamad Abdelfatah 1, Ossama Sajeh Maadarani 2, Muath Alanbaei 3, Rashed Juma Al Hamdan 4

Affiliations

21 November 2022

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doi: 10.24908/pocus.v7i2.15702

Abstract

Detecting dilated coronary sinus when assessing patients in an acute emergency with point-of-care ultrasound (POCUS) is important for differential diagnosis, including the detection of persistent left superior vena cava (PLSVC) and right ventricular dysfunction. Cardiac POCUS with agitated saline injections through the left and right antecubital veins is a simple bedside test to make the diagnosis. We present a 42-year-old woman with first-time rapid atrial flutter in whom POCUS confirmed the presence of dilated coronary sinus and PLSVC.

Keywords: arrhythmia; echocardiography.

Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1. Dilated coronary sinus. Arrow, coronary sinus; L, left atrium; V, left ventricle

Figure 1. Dilated coronary sinus. Arrow, coronary sinus; L, left atrium; V, left ventricle

Figure 2. Transesophageal echocardiography showed an atrial septal defect of the superior sinus venosus type with Left to Right flow. RA, right atrium; LA left atrium; S atrium septum with septum defect

Figure 2. Transesophageal echocardiography showed an atrial septal defect of the superior sinus venosus type with Left to Right flow. RA, right atrium; LA left atrium; S atrium septum with septum defect

Figure 3. Cardiac computerized tomography with emphasis on pulmonary veins was performed. The right atrium (RA) and right ventricle are significantly dilated. There is an anomalous shunt defect at the superior portion of the interatrial Septum. The right superior pulmonary vein (RSPV) is seen having confluence with the right superior vena cava (RSVC) at the level of entrance of RSPV into the mediastinum.

Figure 3. Cardiac computerized tomography with emphasis on pulmonary veins was performed. The right atrium (RA) and right ventricle are significantly dilated. There is an anomalous shunt defect at the superior portion of the interatrial Septum. The right superior pulmonary vein (RSPV) is seen having confluence with the right superior vena cava (RSVC) at the level of entrance of RSPV into the mediastinum.

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