Superior vena cava syndrome
Superior vena cava syndrome (Mediastinal syndrome) | |
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Other names | SVC obstruction bronchogenic carcinoma. Note the swelling of his face first thing in the morning (left) and its resolution after being upright all day (right). |
Specialty | Pulmonology |
Superior vena cava syndrome (SVCS), is a group of symptoms caused by obstruction of the
Characteristic features are
Signs and symptoms
Following are frequent symptoms:
- Difficulty breathing[6]
- Headache[6]
- Facial swelling[6]
- Venous distention in the neck and distended veins in the upper chest and arms[6]
- Migraines (especially if unusual to normal)
- Large decrease in lung capacity
- Facial swelling after bending/laying down
- Upper limb edema[6]
- Lightheadedness[5]
- Cough[5]
- Edema (swelling) of the neck, called the collar of Stokes[7]
- Pemberton's sign[6]
Superior vena cava syndrome usually presents more gradually with an increase in symptoms over time as malignancies increase in size or invasiveness.[5]
Cause
Over 80% of cases are caused by malignant tumors compressing the superior vena cava.
Diagnosis
The main techniques of diagnosing SVCS are with chest
Treatment
Several methods of treatment are available, mainly consisting of careful drug therapy and surgery.
In an acute setting, endovascular stenting by an interventional radiologist may provide relief of symptoms in as little as 12–24 hours with minimal risks.[citation needed]
Should a patient require assistance with respiration whether it be by bag/valve/mask,
Prognosis
Symptoms are usually relieved with radiation therapy within one month of treatment.[5] However, even with treatment, 99% of patients die within two and a half years.[5] This relates to the cancerous causes of SVC found in 90% of cases. The average age of disease onset is 54 years.[5]
See also
References
- ^ "SVC obstruction: MedlinePlus Medical Encyclopedia". medlineplus.gov. Retrieved 4 June 2019.
- PMID 16523051.
- ^ a b Nickloes TA, Lopez Rowe V, Kallab AM, Dunlap AB (28 March 2018). "Superior Vena Cava Syndrome". Medscape. WebMD LLC. Retrieved 3 August 2018.
- ISBN 978-0387310565.
- ^ a b c d e f g h i j k l emedicine > Superior Vena Cava Syndrome. Author: Michael S Beeson, MD, MBA, FACEP, Professor of Emergency Medicine, Northeastern Ohio Universities College of Medicine and Pharmacy; Attending Faculty, Summa Health System. Updated: Dec 3, 2009
- ^ ISBN 978-0-19-920244-7.
- ^ define:collar of Stokes at open-resource-project.org. Retrieved Mars 2011
Further reading
- Wilson LD, Detterbeck FC, Yahalom J (May 2007). "Clinical practice. Superior vena cava syndrome with malignant causes". N Engl J Med. 356 (18): 1862–9. PMID 17476012.
- Randolph HL Wong; Joshua Chai; Calvin SH Ng; et al. (2009). "Transvenous pacing lead-induced Superior Vena Cava Syndrome: What do we know?". Surgical Practice. 13 (4): 125–126. S2CID 59242624.