A woman complaining of dyspnea and chest pain since childhood, was referred to our hospital with an initial diagnosis of biventricular hypertrophic cardiomyopathy. Multimodality imaging evaluation revealed massive right ventricular (RV) hypertrophy and severe RV outflow tract obstruction, with a final diagnosis of double chambered RV associated with small ventricular septal defect with right-to-left shunt and right partial anomalous pulmonary vein return. This represents an uncommon combination of congenital abnormalities, extremely rarely diagnosed in adulthood.

Persistent left superior vena cava draining into the left atrium is a rare condition. We herein report the case of a 34-year-old male admitted at our institution for paroxysmal atrial fibrillation. Investigations revealed a large ostium secundum atrial septal defect, with a persistent left superior vena cava draining into the left atrium, while the coronary veins drained separately into the left atrium. Surgical correction was performed, closing the defect with a patch and connecting the left superior vena cava to the right atrial appendage with an extra-cardiac conduit.