Two is company, three is a crowd.

The use of pacemakers and central venous catheters (CVC) has become commonplace in the field of medicine. In the past, superior vena cava (SVC) syndrome was almost always associated with malignant occlusion of the SVC. However, with the increased use of pacemakers and implantable cardioverter-defibrillators (ICDs) almost 30% of all cases are related to the use of intravascular devices today. We present a case of SVC syndrome in a young patient with prior permanent pacemaker implantation who underwent CVC placement prior to surgery for hypertrophic cardiomyopathy.