# A Case of Incomplete Scimitar Syndrome in a Quinquagenarian Male

## TL;DR

A 59-year-old man with incomplete scimitar syndrome, a rare heart-lung condition, was diagnosed after presenting with severe dizziness and high blood pressure.

## Contribution

This case highlights the rare adult presentation of incomplete scimitar syndrome and emphasizes the importance of medical management for associated pulmonary hypertension.

## Key findings

- The patient had an aberrant right lower pulmonary vein draining into the IVC without congenital heart defects.
- Incomplete scimitar syndrome can manifest in adulthood with symptoms like dyspnea and pulmonary hypertension.
- Medical management of comorbidities led to clinical improvement in the patient.

## Abstract

Scimitar syndrome is a rare congenital cardiopulmonary condition characterized by an anomalous pulmonary venous return from the right lung to the inferior vena cava (IVC). Most patients are diagnosed during infancy. Incomplete scimitar syndrome refers to a variant, where only a portion of the right lung drains abnormally into the IVC without associated cardiac defects. This case involves a 59-year-old man who presented with severe dizziness and hypertensive emergency with a blood pressure of 234/122 mmHg. His past medical history includes hypertension, cerebrovascular accident, prior myocardial infarction, and diabetes mellitus. A computed tomography (CT) without contrast demonstrated an aberrant connection of the right lower pulmonary vein to the IVC. The patient did not have associated congenital heart defects (incomplete scimitar syndrome). He was conservatively treated for his comorbidities with clinical improvement. Incomplete scimitar syndrome manifests late in adulthood as dyspnea during exertion secondary to the development of pulmonary hypertension. Hence, the cornerstone of treatment for pulmonary hypertension is medical control. By concentrating on the adult appearance of incomplete scimitar syndrome, long-term treatment and care may result from the identification of more individuals with incomplete scimitar syndrome as imaging methods advance and awareness increases. Future longitudinal outcome research for such rare conditions is crucial to fill up these information gaps.