Manso Paulo Henrique, Moreira Valéria de Melo, Aiello Vera Demarchi
Ribeirão Preto Medical School-University of São Paulo, Avenida Bandeirantes 3900, Ribeirao Preto-SP, Brazil.
Heart Institute-University of São Paulo, Avenida Dr. Enéas de Carvalho Aguiar 44, 05403-900São Paulo-SP, Brazil.
Eur Heart J Case Rep. 2019 Jun 1;3(2). doi: 10.1093/ehjcr/ytz050.
Scimitar syndrome consists of anomalous pulmonary vein drainage to the inferior vena cava. Its name derives from the image this anomalous pulmonary vein creates on a chest radiograph. We describe a case of normal venous pulmonary vein drainage that also presented the scimitar sign due to an aorto-collateral vessel.
A 15-month-old girl presented with mild dyspnoea and fever. Control chest X-ray showed an image of cardiac dextroposition, hypoplastic right lung, and the 'scimitar sign'. Although the transthoracic echocardiogram confirmed the initial suspicion of anomalous pulmonary venous drainage, the computed tomography (CT) scan showed normal right pulmonary veins connected to the left atrium and revealed that an aorto-collateral vessel caused the scimitar sign.
Although the patient had several typical alterations of the scimitar syndrome, the pulmonary venous connection was normal, and the scimitar sign was due to an aorto-collateral vessel. It might be difficult to describe venous pulmonary connections on the basis of echocardiography, so an angio CT scan proved to be a valuable tool in this scenario.
弯刀综合征包括异常肺静脉引流至下腔静脉。其名称源于该异常肺静脉在胸部X线片上形成的影像。我们描述了一例正常肺静脉引流但因主动脉侧支血管而出现弯刀征的病例。
一名15个月大的女孩出现轻度呼吸困难和发热。胸部X线检查显示心脏右位、右肺发育不全及“弯刀征”影像。尽管经胸超声心动图最初证实怀疑为异常肺静脉引流，但计算机断层扫描（CT）显示右肺静脉正常连接至左心房，并揭示是一条主动脉侧支血管导致了弯刀征。
尽管该患者有弯刀综合征的几种典型改变，但肺静脉连接正常，弯刀征是由主动脉侧支血管所致。基于超声心动图可能难以描述肺静脉连接情况，因此在这种情况下血管CT扫描被证明是一种有价值的工具。
