Central venous catheter malposition presenting as chest pain.

Erroneous positioning of central venous catheters in small tributaries of large central veins is a rare occurrence. We describe three such unusual incidents involving cannulation of the left internal mammary vein. Malposition was suspected when infusion of hypertonic parenteral nutrition led to persistent precordial pain. Unusual chest pain syndromes may indicate central venous catheter malposition and have not previously been described.