Clinical Practice and Cases in Emergency Medicine (Nov 2020)

Case Report of a Left-sided Superior Vena Cava Causing Unique Positioning of Central Line

  • Michael Mancera,
  • Nicholas Genthe,
  • Nicholas Lepa

DOI
https://doi.org/10.5811/cpcem.2020.8.48372
Journal volume & issue
Vol. 4, no. 4

Abstract

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Introduction: Persistent left-sided superior vena cava is a rare congenital venous malformation. While often clinically asymptomatic, these variations in normal anatomy may give rise to complications with central venous catheter placement. Case Report: We present a case of a 71-year-old male who presented to the emergency department with sepsis of unknown etiology. A right-sided central venous catheter was placed, and due to a persistent left-sided superior vena cava the post-procedure chest radiograph showed a uniquely positioned catheter tip within the left atrium. Conclusion: A persistent left-sided superior vena cava may lead to uniquely positioned catheter tip placement on post-procedural imaging. This case demonstrates the need to consider variants in normal venous anatomy, such as persistent left-sided superior vena cava, to aid with correct interpretation of post-procedure imaging findings.