Chest and cardiac imaging: persistent left superior vena cava: practice question

A Radiology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Radiology · Chest and cardiac imaging: persistent left superior vena cava

Sample item

A left-sided central venous catheter is inserted and a chest radiograph shows the catheter running vertically down along the left mediastinal border before curving medially. The patient is otherwise well. What is the most likely explanation?

APersistent left superior vena cava draining into the coronary sinusBCatheter coiled in the right atriumCCatheter placed in the left subclavian arteryDCatheter placed in the left internal mammary vein

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

A. Persistent left superior vena cava draining into the coronary sinus

A persistent left superior vena cava descends lateral to the aortic arch and drains into the coronary sinus. A catheter entering it follows this course and ends in the coronary sinus or right atrium. It is the commonest thoracic venous variant and is usually asymptomatic.

Option by option

A. Persistent left superior vena cava draining into the coronary sinus (correct)
Correct. A catheter running along the left mediastinal border fits a persistent left SVC.
B. Catheter coiled in the right atrium
A catheter coiled in the right atrium would lie to the right of the midline.
C. Catheter placed in the left subclavian artery
An arterial catheter would project over the aortic arch and have pulsatile blood return.
D. Catheter placed in the left internal mammary vein
The internal mammary vein runs close to the sternum, not along the left mediastinal border.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this Radiology question

What is the answer to this Radiology question?

The best answer is A, Persistent left superior vena cava draining into the coronary sinus. A persistent left superior vena cava descends lateral to the aortic arch and drains into the coronary sinus.

Why is "Catheter coiled in the right atrium" not the answer?

A catheter coiled in the right atrium would lie to the right of the midline.

Why is "Catheter placed in the left subclavian artery" not the answer?

An arterial catheter would project over the aortic arch and have pulsatile blood return.

Why is "Catheter placed in the left internal mammary vein" not the answer?

The internal mammary vein runs close to the sternum, not along the left mediastinal border.

What concept does this question test?

It tests Chest and cardiac imaging: persistent left superior vena cava in Radiology. A catheter entering it follows this course and ends in the coronary sinus or right atrium. It is the commonest thoracic venous variant and is usually asymptomatic.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Chest and cardiac imaging: persistent left superior vena cava?

Learn signs with the image, and the disease they point to. Then use the flashcards and the other Radiology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.