Turkish Sword can Track the Way of Pulmonary Vein: A Concealed Finding

Abstract

Scimitar syndrome is an unusual developmental anomaly causing partial anomalous pulmonary venous return (right sided pulmonary veins) with left-to-right shunt at inter atrial septal level. It occurs more commonly in females, with occasional familial occurrence. The clinical presentation is variable. Patient may remain asymptomatic or may present with heart failure. The objective of this clinical case report is to highlight this unusual anomaly to avoid incorrect diagnosis. A girl of 13 years presented with unusual symptom of nausea following taking meal and a systolic murmur. At first she was diagnosed as “ASD Secundum”. But her typical “Turkish sword” feature of chest x-ray helped to identify anomalous drainage of right pulmonary veins into inferior vena cava and make the diagnosis as “Scimitar syndrome”. It is a total corrective anomaly. She was operated through open heart surgery, recovered early and discharged with a stable condition without any complication. This case illustrates the importance of thorough medical history, careful evaluation of investigation for proper diagnosis, treatment procedure and complications of a rare anomaly.

Bangladesh J Child Health 2020; VOL 44 (1) :64-67