Superior vena cava obstruction
Updates to Article Attributes
Superior vena cava (SVC) obstruction can occur from extrinsic compression , intrinsic stenosis or thrombosis thrombosis. Malignancies are the main cause and is considered an oncologic emergency. Superior vena cava syndrome (SVCS) refers to the clinical syndrome with symptoms that results from this obstruction.
Clinical presentation
Clinical presentation depends on the speed, severity and location of superior vena cava obstruction 5. Collateral drainage may develop with slow obstruction and patients may have no or only mild symptoms.
With acute superior vena cava obstruction, symptoms include facial and neck swelling, facial flushing, bilateral upper extremity swelling, neurological signs, dyspnoea, headache and cough.
Pathology
Causes
- malignancy (responsible for SVC syndrome in about ~90% of cases, lung carcinoma and lymphoma are the most common neoplasms associated with this condition) 5
- central venous catheters
- pacemaker wires
- fibrosing mediastinitis
- syphilitic aneurysms
- Behcet disease
Radiographic features
Plain film
Indirect signs on chest x-ray, such as superior mediastinal widening and right hilar prominence that may indicate the presence of mediastinal mass.
CT
Is the imaging modality of choice. Enhanced CT shows the location and severity of the SVC obstruction, superimposed thrombosis, a mediastinal mass or lymphadenopathy, collateral vessels and associated lung masses.
Treatment and prognosis
Treatment of SVCS will depend on the cause of the compression. Thrombolysis and anticoagulation may be indicated on thrombosis. In cases of compression, endovascular treatment with self-expandable bare stents is an effective SVCS therapy 6. With carcinoma or infection, specific drugs or radiation may be used 7.
-<p><strong>Superior vena cava</strong> (<strong>SVC)</strong> <strong>obstruction </strong>can occur from extrinsic compression or thrombosis. Malignancies are the main cause and is considered an oncologic emergency. <strong>Superior vena cava syndrome</strong> (<strong>SVCS</strong>) refers to the clinical syndrome with symptoms that results from this obstruction.</p><h4>Clinical presentation</h4><p>Clinical presentation depends on the speed, severity and location of superior vena cava obstruction <sup>5</sup>. Collateral drainage may develop with slow obstruction and patients may have no or only mild symptoms.</p><p>With acute superior vena cava obstruction, symptoms include facial and neck swelling, facial flushing, bilateral upper extremity swelling, neurological signs, dyspnoea, headache and cough.</p><h4>Pathology</h4><h5>Causes</h5><ul>- +<p><strong>Superior vena cava</strong> (<strong>SVC)</strong> <strong>obstruction </strong>can occur from extrinsic compression , intrinsic stenosis or thrombosis. Malignancies are the main cause and is considered an oncologic emergency. <strong>Superior vena cava syndrome</strong> (<strong>SVCS</strong>) refers to the clinical syndrome with symptoms that results from this obstruction.</p><h4>Clinical presentation</h4><p>Clinical presentation depends on the speed, severity and location of superior vena cava obstruction <sup>5</sup>. Collateral drainage may develop with slow obstruction and patients may have no or only mild symptoms.</p><p>With acute superior vena cava obstruction, symptoms include facial and neck swelling, facial flushing, bilateral upper extremity swelling, neurological signs, dyspnoea, headache and cough.</p><h4>Pathology</h4><h5>Causes</h5><ul>
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