SDMS CME Credit – Persistent Left Superior Vena Cava and Agitated Saline: A Strategically Thinking Sonographer’s Perspective

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Article: Persistent Left Superior Vena Cava and Agitated Saline: A Strategically Thinking Sonographer’s Perspective

Authors: Michael Trump, RCS and Eric Kallstrom, DSL, ACS, RDCS, FASE, FAIUM, FACC

Category: Adult Echocardiography [AE]

Credit: 0.50 SDMS CME Credit

Objectives: After studying the article, you should be able to:

• Discuss how transthoracic echocardiography (TTE), along with agitated saline, is used to detect persistent left superior vena cava (PLSVC).

• Explain the importance of left arm IV insertion and the steps required for saline contrast studies used in echocardiography to diagnose PLSVC.

• Recognize the importance of cardiac sonographers utilizing critical thinking skills in echocardiography to detect anomalies such as PLSVC.

1. According to the article, which is the recommended window for echocardiography during agitated saline administration for persistent left superior vena cava (PLSVC)?

2. B. Apical four chamber

3. C. Parasternal short axis

4. D. Apical five chamber

Saline bubble studies for PSLVC recommend the IV insertion site is a vein located in the:

A. Left jugular vein

B. Right jugular vein

C. Left arm

D. Right arm

The Case Report notes the patient’s complex medical history including:

A. Hyperthyroidism

B. Ventral septal defect

C. Atrial Fibrillation

D. Mitral valve replacement

Figure 2 demonstrates computed tomographic (CT) and 3D reconstruction of PLSVC and the central venous line placed within what vascular structure?

A. Right internal jugular vein

B. Left external jugular vein

C. Right internal jugular vein

D. Left internal jugular vein

The patient’s left ventricular ejection fraction by Simpson’s bi-plane rule was reported as:

A. 58%

B. 67%

C. 28%

D. 16%