Presentation
The patient is post central venous catheter insertion in a setting of an acute myocardial infarction.
Patient Data
This mobile chest X-ray was performed in an intensive care setting and confirmed a newly inserted left internal jugular venous (IJV) access central venous catheter (CVC).
The catheter tip has a 900 posterior bend and appears to terminate in the azygous vein.
There is multichamber cardiomegaly magnified in the AP series.
Pulmonary edema and cardiac decompensation are present in the setting of an acute myocardial infarct. There are no pleural effusions.
There are overlying ECG leads.
Image courtesy: Dr MN Patel.
Case Discussion
An example of a CVC malposition with the catheter tip likely terminating within the azygous vein is demonstrated by the 90-degree posterior bend. In instances of malposition, a lateral view when possible may assist in assessment, alternatively, CT imaging is recommended for a definitive review.
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