Scimitar syndrome: A rare explanation for a common symptom with an osteopathic approach

BackgroundScimitar Syndrome is a rare congenital heart defect involving anomalous return of venous blood from the right lung. It is commonly associated with recurrent pulmonary infections, including pneumonia. Osteopathic manipulative treatment has been proven to improve the clinical course in hospitalized patients with pneumonia.Clinical featuresA 68-year-old female presented with dyspnea for 5 months. Examination disclosed decreased right-sided breath sounds and the presence of right-sided heart sounds. Osteopathic evaluation revealed both acute and chronic somatic dysfunctions and viscero-somatic changes. Chest computed tomography identified severe volume loss on the right with elevation of the right hemidiaphragm, a mediastinal shift towards the right and an anomalous venous drainage in the lower chest. Pulmonary angiogram confirmed Scimitar Syndrome. The patient developed pneumonia and was initiated on antibiotics. Osteopathic manipulation was implemented for symptomatic relief. The patient recovered quickly with a short hospital stay and symptom-free discharge.ConclusionsThis case illustrates the importance of a thorough physical examination in combination with appropriate imaging in the discovery of a rare etiology for the treatment of a common complaint. Further, this is the first case describing the application of osteopathic manipulative medicine to aid in the diagnosis and treatment of the rare condition, Scimitar Syndrome.