Case report   

The Journal of Sports Medicine and Physical Fitness 2001 June;41(2):275-7

Copyright © 2002 EDIZIONI MINERVA MEDICA

language: English

Fortuitously discovered persistent left superior vena cava in young competitive athletes. Clinical implications of sports physicians

Kinoshita N., Hasegawa K., Oguma Y., Katsukawa F., Onishi S., Yamazaki H.

From the Sports Medicine Research Center Keio University, Yokohama, Kanagawa, Japan * Yokohama Heart Cener

This ­report ­describes two ath­letes ­with per­sis­tent ­left super­i­or ­vena ­cava (­PLSVC) acci­den­tal­ly iden­ti­fied dur­ing prep­ar­tic­i­pa­tion med­i­cal eval­u­a­tion. The clin­ical impli­ca­tions of ­PLSVC for ­sports phy­si­cians are ­also dis­cussed. A 16-­year-old ­male ice hock­ey ­player and an 18-­year-old ­male ­high-lev­el ­field hock­ey ­player vis­it­ed our insti­tute for med­i­cal eval­u­a­tion ­prior to par­tic­i­pat­ing in com­pe­ti­tion. Neither com­plained of pal­pi­ta­tion, faint­ness or syn­cope, ­which ­would ­have sug­gest­ed a pos­sible car­diac ­rhythm dis­tur­bance, or had ­been ­informed of any abnor­mal­ities in pre­vi­ous phys­i­cal exam­ina­tions. Nonetheless, ech­o­car­di­og­ra­phy ­revealed dilat­ed cor­o­nary sinus­es, and venog­ra­phy con­firmed ­PLSVC and, in one ­case, ­showed the ­absence of the ­right super­i­or ­vena ­cava. Electrocardiograms ­showed the ­field hock­ey ­player to ­have an ectop­ic atri­al ­rhythm ­with ­left ­axis devi­a­tion of the fron­tal ­plane P-­wave and the ice hock­ey ­player to ­have nor­mal ­sinus ­rhythm. Symptom-lim­it­ed tread­mill test­ing ­revealed noth­ing abnor­mal, and ­after explain­ing the pos­sible ­rhythm instabil­ity and the poten­tial ­risk asso­ciat­ed ­with car­diac sur­gery, the sub­jects ­were per­mit­ted ­full par­tic­i­pa­tion in com­pet­i­tive ­sports. Although infor­ma­tion is ­scarce, avail­able ­data on ­PLSVC sug­gest it is ­benign for com­pet­i­tive ath­letes. Nevertheless, com­pli­ca­tions aris­ing ­from oth­er car­di­o­vas­cu­lar anom­a­lies, ­from poten­tial car­diac ­rhythm dis­tur­banc­es, and ­from car­diac sur­gery neces­si­tat­ed by ­major inju­ries ­should be con­sid­ered ­prior to par­tic­i­pa­tion in com­pet­i­tive ­sports.