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Dextrocardic patient with PICC

Hello everyone,

I was wondering if anyone has encountered this situation.  I had to place a PICC on a patient with dextrocardia.  My immediate thought was that the xray was going to obviously be unusual.  With the patients heart being turned in a mirrored image of a normal heart, then wouldn't it make sense that the PICC would show up in what appears to be the left SVC since the right atrium is now on the left side?  This made perfect sense to me, however the radiologist disagreed and seemed totally perplexed as to where the PICC might actually be.  The xray was perfect to me in that it showed the PICC in the lower SVC but on the right side of the heart rather than the left since the right side of the heart IS the left in this patient.  I've attached the image below:


Please let me know what you all think. 


Thanks so much,

Annette Asbury, RN

PICC Nurse

Sunrise Hospital

Las Vegas, NV

I have to add that the PICC

I have to add that the PICC could actually have been advanced about 2-3cm.  So it's actually mid-lower SVC.

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