A dilated left superior intercostal vein misdiagnosed as aortic dissection

(Mis)placed central venous catheter in the left superior intercostal vein

BACKGROUND Chest X-ray is routinely performed to check the position of the central venous catheter (CVC) inserted through the internal jugular or subclavian vein, while the further evaluation of CVC malfunction is usually performed by contrast venography. In patients with superior vena cava obstruction, the tip of the catheter is often seen in collateral mediastinal venous pathways, rather than...

Left Superior Pulmonary Vein Rhythm Masquerading as Sinus Rhythm

A 55 year old male with a history of frequent symptomatic episodes of paroxysmal atrial fibrillation (AF) for four years was referred to us for catheter ablation. He had earlier tried flecainide and sotalol. However he was unresponsive to both of them. The echocardiogram was normal. Figure 1, left panel demonstrates his baseline electrocardiogram. The relatively slow rate and regularity of this...

Retro-Aortic Left Renal Vein

Left Ventricular Non-Compaction Syndrome Misdiagnosed as Dilated Cardiomyopathy on Several Occasions, Presenting With Recurrent Stroke

A 57-year-old African American female with a history of ischemic cardiomyopathy and a recent stroke with no residual deficits presented with apraxia and confusion. Non-contrast CT scan of the head revealed multiple embolic strokes in both cerebral hemispheres. Transthoracic echocardiography raised the suspicion for increased trabecular meshwork in the left ventricle. Cardiac MRI confirmed the f...

anesthetic management in a patient with type a aortic dissection and superior vena cava syndrome

introduction induction of general anesthesia in patients with superior vena cava (svc) syndrome may cause airway obstruction and cardiovascular collapse. case presentation herein, we introduced a patient with the diagnosis of dissecting aneurysm of the ascending aorta who was candidate for emergency surgery. he also had symptoms of svc syndrome. to maintain airway patency during anesthetic mana...