Thrombectomy, thrombosis, superior vena cava syndrome, superior vena cava obstruction doi. The superior vena cava syndrome svcs comprises various symptoms due to occlusion of the svc, which can be easily obstructed by pathological conditions eg, lung cancer, due to the low internal venous pressure within rigid structures of the thorax trachea, right bronchus, aorta. The photograph shows massive engorgement of collateral subcutaneous veins of the chest and abdomen in a 58yearold man with partial obstruction of the superior vena. Malignancy is the most common cause of the superior vena cava svc syndrome. Superior mediastinal syndrome, also called superior vena cava syndrome results from the presence of an anterior mediastinal mass that compresses the trachea and the superior vena cava. The superior vena caval syndrome is due to obstruction of the superior vena cava, bilateral innominate vein obstruction or arteriovenous fistula between the ascending aorta and superior vena cava. An intrathoracic malignancy is responsible for 60 to 85 percent of cases of superior vena cava syndrome svc syndrome, and svc obstruction is the presenting. In the preantibiotic era, the untreated infections were the.
The obstruction of the vena cava can be caused by extrinsic compression, tumor invasion, thrombosis or insufficient venous return secondary to intraatrial or. Resolution of upper body edema and mats of dilated vessels after balloon angioplasty and venous stenting. Svcs is a medical emergency if associated with laryngeal or cerebral edema. Congenital or acquired abnormalities can affect the diameter of svc. It was first described by william hunter in 1757, in a patient with a large syphilitic aortic aneurysm compressing the svc3,5. The superior vena cava vcs is located in the anterior mediastinum.
Feb 03, 2020 superior vena cava syndrome svcs develops when your superior vena cava is partially or fully blocked. Currently, it is almost exclusively secondary to malignancy. Superior vena cava syndrome secondary to recurrent. Obstruction of the superior vena cava complicates many mediastinal diseases, often impeding blood flow through the superior vena cava and resulting in a collection of signs and symptoms. The syndrome is rarely an oncologic emergency in the absence of tracheal compression and airway compromise. The superior vena cava syndrome is among the most important radiotherapeutic emergencies currently known. The principal vein collecting blood from the head, chest wall, and upper extremities and draining into the right atrium explanation of superior vena cava. Tumour invasion is the cause in 6097% of cases 2, with bronchopulmonary cancers being the most common, followed by lymphomas and metastases. Patients have a cough and dyspnea, particularly when supine, and they have swelling of the head and upper extremities as a result of venous compression. Marcel patterson, md the leveen peritoneojugular shunt has been proposedfor the therapyof ascitic, cirrhotic patients intractable to medical managementor with renal insufficiency.
Pdf superior vena cava in a patient with superior vena. The medical care includes anticoagulants, glucocorticoids, diuretics, as well as. Superior vena cava svc syndrome was originally described as being secondary to an infection. Superior vena cava syndrome revisited japanese journal of. Superior vena cava syndrome discharge care what you. Superior vena cava syndrome svcs is a group of symptoms that occur when there is pressure on the superior vena cava, or it is partially blocked and blood cant flow back to the heart normally. Blood from your upper body normally flows through the superior vena cava and into the right side of your heart. Initial reports empha size its success and its safety,1,2but with wider usage more complications. Superior vena cava svc syndrome is a clinical condition that occurs as a result of obstruction of the svc, leading to interrupted venous return from the head, thorax, and upper extremities to the right atrium.
Superior vena cava syndrome svc syndrome superior vena cava syndrome svc syndrome. With the increasing use of intravascular devices, the incidence of the svc syndrome arising from benign etiologies is increasing. Superior vena cava syndrome svcs develops when your superior vena cava is partially or fully blocked. Superior vena cava syndrome svcs is mechanical obstruction of the superior. Lymphoma or other tumors located in the mediastinum can also cause compression of the superior vena cava less often, the superior vena cava can become blocked with a blood clot from within. Superior vena cava syndrome statpearls ncbi bookshelf. Value of radiotherapy in superior vena cava syndrome.
Superior vena cava syndrome discharge care what you need. It is a largediameter 24 mm short length vein that receives venous return from the upper half of the body, above the diaphragm. Superior vena cava syndrome svcs is a medical condition which consists of the obstruction of blood flow through the superior vena cava. In this report, we described a case of svcs, which was secondary to the compression by a huge. Sep 19, 2016 superior vena cava syndrome is chiefly associated with malignancy. It can occur due to both benign and malignant causes with the. Multidisciplinary treatment planning for those with obstruction due to. Malignancyrelated superior vena cava syndrome uptodate. It is a medical emergency and most often manifests in patients with a malignant disease process within the thorax. William hunter first described the syndrome in 1757 in a patient with syphilitic aortic aneurysm. This contrasts with studies in the early 1950s in which a large proportion of cases were nonmalignant. Superior vena cava syndrome svcs is a relatively common sequela of mediastinal malignancies and may cause significant patient distress.
Superior vena cava syndrome svcs is defined as a condition that occurs when the obstruction of the superior vena cava interrupts blood flow from the head, upper extremities, and thorax to the right atrium and can present a lifethreatening situation. Superior vena cava syndrome svcs is obstruction of blood flow through the superior vena cava svc. The superior vena cava svc is a large valveless venous channel formed by the union of the brachiocephalic veins. The majority of cases are caused by malignant tumors within the mediastinum, most commonly lung cancer and nonhodgkins lymphoma, directly compressing or invading the svc wall. A case of svc syndrome presenting with dyspnea, facial swelling, neck distension and cough developed over a period of 10 days is reported.
These signs and symptoms together constitute the superior vena cava syndrome svc syndrome, first described by william hunter in 1757 as a complication of. The superior vena cava is a large vein that transmits blood from the upper body back to the heart. Definition the superior vena cava is the major vein in the chest that carries blood from the upper part of the body in to the heart. Svcs is a significant disorder affecting up to 10 % of small cell lung cancer sclc patients and 24 % of all lung cancer patients. Mar 17, 2015 superior vena cava syndrome svc syndrome slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. Chronic upper extremity deep vein thrombosis uedvt and superior vena cava syndrome svcs are becoming increasingly common due to the use of indwelling catheters and implantable central venous. Treatment depends on the etiology of the obstructive process. The superior vena cava syndrome svcs is defined as the set of signs and symptoms derived from superior vena cava obstruction, both intrinsic obstruction and extrinsic compression, which causes an increase in venous pressure in the upper. More than 60% of cases of superior vena cava obstruction are caused by malignant causes, typically a tumor outside the vessel compressing the vessel wall. Review of evolving etiologies, implications and treatment strategies.
Malignancies are the main cause and are considered an oncologic emergency. Superior vena cava syndrome canadian cancer society. Treatment the following sections will emphasize the management of malignant superior vena cava svc syndrome tumor invasion. Superior vena cava syndrome svcs is a medical emergency which consists of the obstruction of blood flow through the superior vena cava. Superior vena cava article about superior vena cava by.
The most common cause of superior vena cava syndrome is cancer. Superior vena cava syndrome svcs is a group of symptoms that can occur in people who have lung cancer, lymphoma, or other cancers that involve the center of the chest. Description superior vena cava syndrome is a partial occlusion of the. If the obstruction of the superior vena cava occurs rapidly, there may not be time for other blood vessels called collateral blood vessels or circulation to accommodate the increased blood flow that takes place. If this vein is compressed by outside structures, or if a thrombus or clot develops within it, return blood flow to the heart is impeded. Volume 77, may 2006309 dermatologic signs of an underlying malignant neoplasm. Review of evolving etiologies, implications and treatment.
Superior vena cava syndrome revisited japanese journal. Superior vena cava syndrome symptoms, diagnosis and. Superior vena cava syndrome related fluid collection in. In superior vena cava syndrome svcs, this vein has. Superior vena cava syndrome an overview sciencedirect. Mar 27, 2020 superior vena cava syndrome svcs is obstruction of blood flow through the superior vena cava svc.
Superior vena cava syndrome definition of superior vena. Superior vena cava syndrome svcs is a collection of symptoms that usually occur in patients who have lung cancer, nonhodgkin lymphoma, or other cancers. Introduction superior vena cava syndrome svcs is obstruction of blood flow through the superior vena cava svc. Superior vena cava syndrome due to mediastinal gardner fibroma presenting as syncope. To study the relationship between hemodynamic changes and radiological findings. The syndrome was originally described as being secondary to an infection, such as tuberculosis, or a syphilitic aortic aneurysm 24. Svc obstruction may result from the presence of a mass in the middle or anterior mediastinum generally to the right of midline, consisting of. Initial reports emphasize its success and its safety,1. Superior vena cava syndrome svcs, is a group of symptoms caused by obstruction of the superior vena cava svc, a short, wide vessel carrying circulating blood into the heart. San francisco, california nalthough the superior vena cava syndrome is a well known clinical and radiologic entity, intrinsic diseaseof the aorta is usually not a prime etiologic con. It is almost always due to malignant disease and therefore no time should be wasted in establishing the histological diagnosis of the malignant tumor which causes the superior vena cava obstruction. It transports blood from our arms, chest, neck, and head to our hearts.
It carries one third of the venous return to the heart. The superior vena cava is one of the primary veins within our bodies. If you continue browsing the site, you agree to the use of cookies on this website. Superior vena cava article about superior vena cava by the.
It receives blood from the upper half of the body except the heart and returns it to the right atrium. A restriction of the blood flow occlusion through this vein can cause superior vena cava syndrome svcs. Endovascular treatment of superior vena cava syndrome. This condition is where some internal obstruction of external compression of superior vena cava results in a variety of complications. An intrathoracic malignancy is responsible for 60 to 85 percent of cases of superior vena cava syndrome svc syndrome, and. Superior vena cava syndrome also known as svcs, is a group of symptoms caused by obstruction of the superior vena cava. San francisco, california nalthough the superior vena cava syndrome is a well. This summary explains svcs and its treatment in adults and children. In superior vena cava syndrome svcs, this vein has become obstructed or compressed to some degree. Superior vena cava syndrome is caused by obstruction of the svc either by wall stenosis, extrinsic compression or internal thrombus. Primary or metastatic cancer in the upper lobe of the right lung can compress the superior vena cava.
The superior vena cava is the large vein that carries blood from the head, neck, arms and chest to the heart. Superior vena cava svc syndrome is a collection of clinical signs and. Superior vena cava syndrome is referred to as a constellation of symptoms and signs caused by obstruction of superior vena cava. Superior vena cava syndrome svcs refers to the clinical syn. This causes more pressure in the veins and face, which leads to a buildup of fluid or swelling.
The resulting increased venous pressure in the upper body may cause edema of the head, neck, and upper. The superior vena cava is located in the middle of the chest and is surrounded by rigid structures and lymph nodes. Superior vena cava syndrome mediastinal syndrome other names. In the majority of patients with nonsmallcell lung cancer, relief of symp toms of obstruction of the superior vena cava re sults from treatment of. Lung cancer is the most common cause of superior vena cava syndrome svcs and requires timely recognition and management. A cancerrelated medical emergency more pulmccm topic updatesmultiple cancers are expected to rise in prevalence in the u.
Blood from your upper body normally flows through the superior vena cava and into the right side of your. The superior vena cava is a large vein located in the upper chest, which collects blood from the head and arms and delivers it back to the right atrium of the heart. Superior vena cava syndrome in thoracic malignancies. Superior vena cava syndrome svcs results from the impair. Treatment should also be individualized and should not be undertaken until a. Superior vena cava svc syndrome occurs in approximately 15,000 people in the united states each year. The superior vena cava svc is the superior of the two venae cavae, the great venous trunks that return deoxygenated blood from the systemic circulation to the right atrium of the heart. Waardenburg syndrome and left persistent superior vena cava year. The treatment of malignant obstruction histological diagnosis by sputum. Superior vena cava syndrome an overview sciencedirect topics. As a consequence, various forms of therapy have been promptly. The superior vena cava svc carries blood from the head arms and upper torso to the heart.
Congenital or acquired abnormalities can affect the. Sep 01, 2017 the superior vena cava is one of the primary veins within our bodies. A patient with svcs requires immediate diagnostic evaluation and therapy. Note the swelling of his face first thing in the morning left and its resolution after being upright all day right. Superior vena cava svc obstruction can occur from extrinsic compression, intrinsic stenosis, or thrombosis. The treatment goals are to relieve the symptoms and to cure the underlying cause.
Treatment should also be individualized and should not be undertaken until a diagnosis is obtained. The superior vena cava syndrome american journal of medicine. Superior vena cava syndrome in a person with bronchogenic carcinoma. Superior vena cava syndrome svcs, a clinical manifestation arising from compression of the thinwalled superior vena cava svc, was first described by william hunter in 1757 and can be caused by a variety malignancies hunter and johnston 1757. This presentation is limited to a discussion of obstruction of the superior vena cava, either partial or complete. Superior vena cava syndrome secondary to aortic disease. The superiorvena cava syndrome a complicationof the leveeneshunt gary m. Superior vena cava syndrome is chiefly associated with malignancy. Superior vena cava syndrome archives of the balkan. The symptoms that result from compression of the large vein that carries blood down to the heart. Malignant diseases account for most of the svcs in our chinese patients. Background superior vena cava syndrome is the result of compression, invasion, or thrombosis of this thinwalled blood vessel, which leads to impaired venous drainage and congestion. Acthdependent hypercortisolemia in a patient with a pituitary microadenoma and an atypical carcinoid tumour of the thymus.
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