Partial anomalous pulmonary venous connection echocardiography


 * Associate Editor(s)-In-Chief: Priyamvada Singh, M.B.B.S. [mailto:psingh@perfuse.org], Keri Shafer, M.D. [mailto:kshafer@bidmc.harvard.edu]; Assistant  Editor(s)-In-Chief: Kristin Feeney, B.S. [mailto:kfeeney@perfuse.org]

Overview
Although not the most preferred methodology, chest x rays may be used as a diagnostic tool in the evaluation of a partial anomalous pulmonary venous connection. Findings commonly include evidence of increased vascular markings and cardiomegaly.

Echocardiographic Findings
The presence of right ventricular dilation may be the first sign that PAPVC is present. The next step is to visualize all the major pulmonary veins and their points of insertion into the heart. The use of agitated saline and contrast echocardiography can be of help in more refined imaging of the venous architecture and the connections to the heart. When agitated saline is injected in the left arm vein, there may be negative contrast in the innominate vein at the side of the anomalous venous drainage from a left pulmonary vein in patients with PAPVC. Transesophageal echocardiography may also be useful in further imaging the venous structures. Becuase PAPVC is associated with ASDs, the interatrial septum should be carefully evaluated.