Introduction: Diagnostic and therapeutic attitude in a young woman of 26 years, who presented in emergency with chest stings. Methods: Case report of a patient, 26 years old, presenting nonspecifi c complaints, echocardiographically with dilated right cavities, diagnosed with sinus venosus atrial septal defect with partial anomalous pulmonary venous drainage and persistent left SVC, with echo and MRI signs of severe PAH. Cardiac catheterization was done to assess opportunity of congenital malformations’ surgical repair. Results: Cardiac catheterization revealed normal pulmonary and systemic vascular resistances, without signifi cant PAH, the patient was operated, after surgery with a slow recovery of right ventricular function. Conclusions: Surgical correction is recommended in significant DSA even in adults, as long as there is not a signifi cant PAH. Transthoracic echocardiography is of major importance in evaluating patients presenting to the emergency, even if they sometimes present atypical complaints. Persistent left SVC is a common thoracic venous anomaly, harmless, but of major importance to patients undergoing heart surgery