Portable chest radiography, limited by the patient’s body habitus, showing bilateral retrocardiac opacities and mild cardiomegaly. A left internal jugular central venous catheter extends through the hemiazygos vein; the catheter tip is most likely located in a left intercostal vein (arrow). A chart review revealed that the same malpositioning was present two months earlier. The patient experienced burning pain in the chest during a crystalloid bolus infusion.