Central venous catheter malposition presenting as chest pain

Area of Science:

• Vascular Surgery
• Radiology
• Critical Care Medicine

Background:

• Central venous catheters (CVCs) are essential for administering medications and nutrition.
• Proper CVC placement is crucial for patient safety and effective treatment.
• Malposition can lead to serious complications.

Observation:

• Three cases of CVC malposition are reported.
• Cannulation occurred in the left internal mammary vein, a small tributary of a large central vein.
• Patients experienced persistent precordial pain during parenteral nutrition infusion.

Findings:

• Erroneous CVC positioning in small venous tributaries is uncommon.
• Left internal mammary vein cannulation represents a rare malpositioning.
• Precordial pain is a potential indicator of CVC malposition.

Implications:

• Clinicians should consider CVC malposition in patients with unexplained chest pain.
• Unusual chest pain syndromes associated with CVC malposition require further investigation.
• This highlights the importance of vigilant monitoring and imaging for CVC placement.