CTICasesLevoatrial Cardinal Vein in Turner Syndrome
Imaging findings
Chest radiograph demonstrates a prominent curvilinear opacity in the left upper hemithorax. CT angiogram reveals a coarctation of the aorta and a large, anomalous, meandering systemic-to-pulmonary venous connection. This tortuous vessel (a levoatrial cardinal vein) runs lateral to the aortic arch and communicates directly with both the superior and inferior left pulmonary veins before draining into the left atrium.
Key takeaways
A levoatrial cardinal vein is a rare congenital vascular anomaly representing a persistent embryonic connection between the systemic venous system (brachiocephalic vein or SVC) and the pulmonary veins or left atrium. In patients with Turner syndrome, who are predisposed to aortic coarctation and other cardiovascular anomalies, this vein can establish a bi-directional shunt, placing patients at risk for systemic emboli and paradoxical stroke.
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