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Superior Vena Cava Syndrome
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- The superior vena cava is the large blood vessel that collects the blood from all of the veins in the upper part of the body and then returns this blood to the heart. If the superior vena cava becomes obstructed, then blood and fluid back up into the upper body. This may occur because of a clot or tumor extension in the superior vena cava or due to external pressure on the superior vena cava (tumors and other causes such as infections).
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- Neck swelling
- Facial swelling
- Face/neck flushing
- Arms swelling
- Dizziness
- Headache
- Visual Problems
- Headache
- Fainting
- Veins on chest become prominent
- Confusion
- Hoarseness
- Bending over or lying down makes symptoms worse
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- Tumors such as Lung Cancer or Lymphoma
- Chronic Fibrotic Mediastinitis (inflammation located in the cavity where the superior vena cava enters the heart. It is caused by medications and infections such as Tuberculosis)
- Thrombophlebitis i.e., blood clots that extend into the superior vena cava
- Individuals who have a central catheter (such as Central lines)
- Constrictive Pericarditis
- Aortic Arch Aneurysm
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- Elevated venous pressure in the arms
- A Bronchoscopy is often performed due to the high likelihood of lung disease (e.g., Lung Cancer) being the cause
- Chest X-Rays and CT scans look for the nature of the obstruction
- Venography or Doppler Ultrasound can be helpful to determine if there is a blood clot or tumor in the superior vena cava
- An MRI is sometimes helpful
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- Intravenous diuretics such as Lasix may be considered
- Mediastinal radiation for tumors/Lymphoma
- Chemotherapy especially if the cause is Lymphoma
- Thrombophlebitis (blood
clots) -- thrombolytic agents (e.g., Urokinase) for clots. Intravenous Heparin may be considered for less threatening clots or after completion of the treatment.
- Surgical bypass of the obstruction
- For Mediastinal Fibrosis or Constrictive Pericarditis --
excision of the fibrous tissue around the superior vena cava, and treatment of the underlying cause.
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- The individual needs emergency medical treatment. Untreated, death or cerebral hemorrhage (bleeding into the brain) may occur.
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