A Rare Presentation of Duplicate Superior Vena Cava Precipitating Premature Atrial Contractions: A Case Report and a Review of the Literature.

Millions of central lines are placed each year worldwide for life-saving measures. We present a case of left internal jugular (IJ) triple lumen catheter (TLC) placement for life-saving vasopressors, which appeared to be in the left mediastinum after a confirmed chest X-ray. After correlation with a previous MRI of the heart with and without contrast, duplication of the superior vena cava (SVC), also known as persistent left SVC (PLSVC), was discovered. PLSVC often causes no symptoms to affected individuals and is usually first found as an incidental finding discovered during thoracic surgeries, cardiovascular interventional procedures, and central line insertions. Placement of TLC or central venous catheter (CVC) can be challenging in such patients and may lead to life-threatening complications such as severe arrhythmias, cardiogenic shock, pneumothorax, and tamponade. Knowing such anomalies can prevent unnecessary catheter removal and help determine the origin of some arrhythmias and dilated heart chambers in these patients.