IMAGES IN MEDICINE
Scimitar syndrome on chest x ray
1 Department of Medicine, Queen Mary Hospital, the University of Hong Kong, Hong Kong
2 Department of Diagnostic Radiology, Queen Mary Hospital, the University of Hong Kong, Hong Kong
3 Cardiac Medical Unit, Grantham Hospital, Hong Kong
Correspondence to:
Dr M-H Jim, Cardiac Medical Unit, Grantham Hospital, 125 Wong Chuk Hang Road, Hong Kong; jimmanh2002@yahoo.com
Accepted 27 June 2008
| The first 150 words of the full text of this article appear below. |
A 39-year-old asymptomatic woman was referred for further evaluation of a systolic murmur (grade 2/6) over the pulmonary area. Physical examination was otherwise unremarkable. Resting electrocardiography was normal as well. Transthoracic echocardiography revealed cardiac dextroposition, dilated right atrium and ventricle. However, no significant valvular lesions were detected, and both the inter-atrial and inter-ventricular septa appeared intact. Chest x ray showed dextroposition of the heart with right mediastinal shift and local pulmonary plethora at the right lung field. Interestingly, an abnormal, broad based, curved vascular shadow extending from the medial right hemidiaphragm to the right helium was observed (fig 1). These roentgenological features were compatible with anomalous pulmonary venous drainage (Scimitar syndrome).
Figure 1 Chest x ray showing an abnormal, broad based, curved shadow extending from the medial right hemi-diaphragm to the right helium suggestive of the Scimitar vein (arrow).
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Right heart catheterisation with oximetry detected a step-up of O2 saturation
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