PMC9110049_01
Bubble study showing bubbles in the left-sided chambers before the right.
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The bubbles appeared initially in the left-sided cardiac chambers before the right-side chambers, which is extremely unusual (Figure 1).
2D and 3D CT angiogram of the chest showing the brachiocephalic vein stenosis with extensive collateralization.
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A CT angiogram of the chest showed a persistent left superior vena cava (SVC) with anomalous venous vasculature consistent with severe stenosis of the brachiocephalic vein with significant collateralization (Figure 2).
On the left: Small density suggestive of a vegetation on the mitral valve. On the right: Small PFO seen on color flow doppler.
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A transesophageal echocardiography showed a small patent foramen ovale with small densities on the mitral valve (Figure 3).