SVC syndrome caused by a too tight suture at the cannula sit | Figure 1

SVC syndrome caused by a too tight suture at the cannula site.

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Coronal (Image 1) and axial (Images 2 and 3) contrast-enhanced CT reveal the 'hot quadrate' sign (arrow) due to superior vena cava occlusion (arrowhead). In this patient, the thrombus extends into the right atrium (arrowhead, image 3). The hot quadrate sign occurs due to collateral venous flow around the obstructed superior vena cava. In this setting, contrast passes from the upper extremity to the inferior vena cava via collateral veins such as the internal thoracic, superior and inferior epigastric, and paraumbilical veins.](https://app.figure1.com/case-detail/03a94168-bda2-4f59-ad84-c3dfe6d58240)



Frontal view of the chest without (image 1) and with (image 2) annotation shows an abnormal course of the left internal jugular port. The distal portion of the port is directed medially and resides within the azygos vein. Normally, the tip of a neck or upper extremity venous catheter should reside within the superior vena cava. Larger catheters may terminate within the right atrium. The azygos vein location is not considered central and, in most cases, should be repositioned.](https://app.figure1.com/case-detail/06d5b1eb-e8f1-4854-9f16-b570339a882d)



Chest radiograph following replacement of the left upper extremity PICC with a right upper extremity PICC shows the tip of the catheter (arrow) in the right atrium. On the previous image, the catheter remained to the left of the midline and left of the right mainstem bronchus consistent with an arterial location within the aorta. After replacement, the catheter tip is in the venous system. However, it remains in an abnormal location. The expected location of the PICC is in the superior vena cava. On radiograph, this tip should be within two vertebral segments of the carina. #FridayQuizDay #FridayQuiz](https://app.figure1.com/case-detail/0c9b59e1-7edc-4e13-a7f6-1267706b7a34)



cannulation in 22 days old baby with obstructed TAPVD+CAVSD+double SVC+double IVC](https://app.figure1.com/case-detail/14e29201-e46a-46ff-884a-9f4561c086d1)

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A 52-year-old man presented with a 20-minute history of chest pain radiating to the left shoulder and neck, associated with dyspnea and diaphoresis.
He had a history of hypertension, long-term smoking, and a sedentary lifestyle.
On physical examination, bibasilar crackles were noted on lung auscultation. An electrocardiogram (ECG) was performed in the primary care setting, and the patient was promptly referred to the emergency department.](https://app.figure1.com/case-detail/ae0fe999-6875-4474-94f0-ad823dbb9b3a)



A 28-year-old woman presented with a 3-day history of intense pruritus over the lower back. She reported no recent travel or exposure to new environments. She cares for a small kennel with approximately eight dogs rescued from the streets.
Physical examination revealed multiple small vesicles, some clustered and others scattered, predominantly involving the lumbar region and the left gluteal area.](https://app.figure1.com/case-detail/c271070f-2bc7-4052-9895-635277e1a7d5)



A 4-month-old male infant presented with skin lesions localized to the chin for the past 3 days. Physical examination revealed multiple small pustules with surrounding inflammatory signs on the chin, along with a few scattered papules on the chest.](https://app.figure1.com/case-detail/48f41642-b9db-4089-b120-a94ee52328de)



patient in late teens presenting after a collapse, no chest pain, no previous cardiac history, no history of sudden death in family, are there any features in this ekg that would warrant further work-up or is this just a pediatric ekg?](https://app.figure1.com/case-detail/2af390e1-ace8-40ed-ba1c-98fb2d72f4c5)