Atresia of the right atrial orifice of the coronary sinus with persistent left superior vena cava: a case report

A 39-year-old woman presented with atresia of the right atrial orifice of the coronary sinus with a persistent left superior vena cava detected at cardiac catheterization. She was admitted with frequent episodes of angina at rest and on exertion. Coronary angiography, including spasm provocation test, yielded normal results. However, left coronary arteriography demonstrated a dilated coronary sinus and a persistent left superior vena cava draining into the innominate vein. The contrast medium leaked slightly into the right atrial cavity through the obstructed orifice of the coronary sinus. Atresia of the coronary sinus orifice is a rare malformation usually found at autopsy. Only 3 cases have been reported in Japan. This is the first adult Japanese case detected when the patient was still alive.