Print Email
 

Clinical Images

Where is the Left Central Venous Catheter Inserted?

Abubakr Bajwa, Candice Baldeo, Ena Gupta, Avinash Ramdass

April 3, 2015

A 62 year old male with COPD, CAD with AICD implantation, and OSA was admitted for worsening dyspnea. Severe pulmonary artery hypertension was confirmed with right heart catheterization and echocardiography and he was started on intravenous epoprostenol.

Chest X-ray following insertion of a left central venous catheter showed likely placement of the catheter in the internal carotid artery (Figure 1). However, pressures transduced from this newly placed catheter displayed a venous waveform with pressures ranging from 7-15mmHg suggesting that this was not an arterial catheterization. CT chest revealed a left azygous vein in which the catheter had engaged (Figure 2).

Left-central-venous-catheter-Figure-1.png

 Figure 1

Left-central-venous-catheter-inserted-Figure-2.png
Figure 2


 


Click here to view the answer

References

  1. Suat Keskin, Zeynep Keskin,Nevin Sekmenli. The Independent Right and Left Azygos Veins with Hemiazygos Absence: A Rare Case Presentation. Case Reports in Vascular Medicine, Volume 2013, Article ID 282416.
  2. Lydia S Quadros, Bhagath Kumar Potu, Anitha Guru,Thejodhar Pulakunta, Biswabina Ray, Suhani Sumalatha D’Silva,Sylvia Sequeira and Huban Thomas. Anomalous azygos venous system in a south Indian cadaver. A case report. Cases Journal 2009, 2:6746.

 

Authors

Candice Baldeo-PGY2 Internal Medicine resident at University of Florida, Jacksonville.

Ena Gupta- PGY2 Internal Medicine resident at University of Florida, Jacksonville.

Avinash Ramdass-First year fellow in Pulmonary/Critical Care at University of Florida, Jacksonville.

Abubakr Bajwa-Attending in Pulmonary/Critical Care at University of Florida, Jacksonville.



 

Submit content to JGIM

JGIM encourages submission of articles aimed at improving patient care, education, and research in primary care and general internal medicine in all settings. Submissions must be original and not currently under consideration for publication in another peer- reviewed medium (paper or electronic).

Learn How to Submit Here

 

FEATURED ARTICLE

 

Darlyn Victor, MD, Paul Moots, MD and Jacqueline Fischer, MD

October 13, 2016

A 39-year-old African-A....

Read Article
 

Most Viewed Articles

73 Views

The Role of Community-Based Participatory Research to Inform Local Health Policy: A Case Study.

O’Brien, Matthew J.; Whitaker, Robert C.

Read Article| Download PDF
25 Views

The Role of Community-Based Participatory Research to Inform Local Health Policy: A Case Study.

O’Brien, Matthew J.; Whitaker, Robert C.

Read Article| Download PDF
31 Views

The Role of Community-Based Participatory Research to Inform Local Health Policy: A Case Study.

O’Brien, Matthew J.; Whitaker, Robert C.

Read Article| Download PDF

Most Recent Web Only Content

January

17

On the Penetrating Capacity of Ultrasound

Sarah Bugg

Read Article

December

20

Painful Eruption in a Mountain Biker

Jasna Ikanovic, MD and Animita Saha, MD

Read Article

November

19

Adverse Events In US Hospitals:1 in 3 Admissions Has At Least One Adverse Event

SGIM Evidence-Based Medicine Task Force

Read Article

August

25

Diagnostic Schema

Denise M. Connor, Rabih Geha, Mark Henderson, Jeff Kohlwes

Read Article