Abnormality of venous return associated with congenital heart defect in an adult patient.

Systemic venous abnormalities are common and in some cases may be associated with congenital heart defects. We report here a case of a 67-year-old woman with bilateral superior vena cava with interruption of the inferior vena cava with hemiazygous continuation in the context of left atrial isomerism. These abnormalities were associated with a small secundum atrial septal defect and patent foramen ovale. The dilated hemiazygous vein was a potential mimicker of aortic pathology. The dilated coronary sinus was a sign of anomalous venous return. The echocardiographist should search systematically for a congenital heart defect on detection of this type of anomalous venous return. Radiological imaging can help to confirm the diagnosis.