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Superior Vena Cava Syndrome

Reviewed 06/2018
 


BASICS

DESCRIPTION

  • Partial or complete obstruction of the superior vena cava (SVC) (1):

    • ~60% due to malignant causes

    • 20–40% thrombosis or nonmalignant causes

  • Usual course: acute; usually 2 to 4 weeks from...

DIAGNOSIS

SVC syndrome presents as a constellation of symptoms caused by the impairment of blood flow through the SVC to the right atrium. A variety of imaging techniques can be performed to confirm t...

TREATMENT

GENERAL MEASURES

  • Goal: Remove compression, relieve symptoms, and prevent complications (3,4)[C].

  • Radiotherapy mainly in non–small cell lung cancer and non-Hodgkin lymphoma

  • Neoadjuvant chemoradi...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

  • Bed rest, elevate patient's head, and limit bending down to decrease the hydrostatic pressure.

  • SVC syndrome is often associated with terminal illness; discuss adva...

REFERENCES

1
Wilson LD, Detterbeck FC, Yahalom J. Clinical practice. Superior vena cava syndrome with malignant causes. N Engl J Med.  2007;356(18):1862–1869. [View Abstract on OvidMedline]
2
Yu JB,...

ADDITIONAL READING

  • Rice TW, Rodriguez RM, Light RW. The superior vena cava syndrome: clinical characteristics and evolving etiology. Medicine (Baltimore).  2006;85(1):37–42.

  • Wan JF, Bezjak A. Supe...

CODES

ICD10

I87.1 Compression of vein 

ICD9

459.2 Compression of vein 

SNOMED

63363004 Superior vena cava syndrome (disorder) 

CLINICAL PEARLS

  • Lung cancer is the leading cause of SVC syndrome; other malignant causes include lymphoma and metastatic breast and prostate cancer.

  • Percutaneous stenting can provide immediate relief (...

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