# Congenital Anomaly Diagnosis of Typical Cardiac Chest Pain Due to Thebesian Veins Draining Into the Left Ventricular Chamber: A Case Report and Review of Literature

## TL;DR

A case report describes a 77-year-old woman with chest pain caused by congenital Thebesian veins draining into her heart, leading to symptoms resembling heart disease.

## Contribution

This case highlights Thebesian veins as a rare cause of cardiac chest pain and contributes to understanding their clinical presentation.

## Key findings

- The patient's symptoms were linked to persistent Thebesian veins, not ischemic heart disease.
- Literature review shows consistent clinical patterns in cases involving anomalous Thebesian veins.
- Thebesian veins can cause chest pain and ECG changes mimicking ischemia.

## Abstract

Thebesian veins are microfistulae that drain the coronary arteries directly into one or more chambers of the heart. Persistence of these anomalous connections into adulthood can lead to shunting of blood away from the myocardium causing typical chest pain symptoms with electrocardiogram changes consistent with ischemia. We describe a case of a 77-year-old female who underwent ischemic evaluation for her symptoms found to have significant Thebesian veins. We also engage in a comprehensive review of the literature finding consistencies in the way these cases are presented in the literature.