Total anomalous pulmonary venous drainage: Case presenting with prominent right supraclavicular thrill and loud continuous murmur

Abstract

A 15 year old Indian boy was discovered to have a very loud continuous murmur over the right supraclavicular region. Cardiac catheterization findings demonstrated an atrial septal defect and a left to right shunt at the level of the right innominate vein. At thoracotomy, total anomalous pulmonary venous drainage was found. The dilated vertical vein arising from the common pulmonary vein was narrowed to about 1.2 cm in diameter at its site of entry into the right innominate vein, causing blood to flow into the latter vessel in a jet-like fashion, thus producing the loud continuous murmur.