Newborn with increasing respiratory distress after subclavian venous catheter placement for total parenteral nutrition (TPN) 2 days ago

CXR of pericardial effusion due to malposition of central line in the pericardial space — CXR AP (left) shows the tip of the newly placed left subclavian venous catheter to project deep within the right atrium while the cardiac silhouette is normal in size. CXR AP 2 days later (right) shows the catheter tip unchanged in position while the cardiac silhouette has increased markedly in size in the interval. Cardiocentesis returned TPN.

The diagnosis was subclavian venous catheter malposition in the pericardial space resulting in a pericardial effusion and cardiac tamponade.