[Partial anomalous pulmonary venous connection to inferior vena cava (incomplete type of scimitar syndrome) in an elderly patient].

A 71-year-old woman presented with recent onset of dyspnea and fatigue on moderate exertion. She had been well during her entire life and had had three pregnancies and deliveries. Cardiomegaly was noted at the age of 30. On physical examination, systolic murmur was detected at the lower left sternal border. The chest X-ray showed cardiomegaly, increased pulmonary vascular markings and elevated right diaphragm. The electrocardiogram showed left ventricular hypertrophy. The echocardiography showed enlargement of right ventricle and atrium, massive tricuspid regurgitation and anomalous venous flow connected to the inferior vena cava from its right-posterior side. Cardiac catheterization demonstrated mild pulmonary hypertension and O2 step-up at the level of the anomalous venous connection to the inferior vena cava. On pulmonary arteriography, left pulmonary venous flow return to the left atrium and atrial septal defect was not found. Veins from the right lung met to form one vessel, went downward, and connected to the inferior vena cava at the level of Th12. L-R shunt was 45% and Qp/Qs was 1.83. Isolated partial anomalous pulmonary venous connection is a rare finding, and it is thought that the natural prognosis is good. The existence of our case, diagnosed at the age of 71, supported this concept.