Syndrome, superior vena cava

The symptoms that result from compression of the large vein that carries blood down to the heart.

The superior vena cava is a large vein that transmits blood from the upper body back to the heart. The superior vena cava is located in the middle of the chest and is surrounded by rigid structures and lymph nodes. The structure bordering the superior vena cava include the trachea, aorta, thymus, right bronchus of the lung and pulmonary artery.

Compression of the superior vena cava by disease of any of the structures or lymph nodes surrounding the superior vena cava can cause the superior vena cava syndrome.

The superior vena cava syndrome is characterized by swelling of the face, neck and/or arms with visible widening (dilation) of the veins of the neck. Patients often have a persistent cough and shortness of breath. Others symptoms can be present including hoarseness, swelling around the eyes, fatigue, chest pain, headaches, and dizziness.

The causes of the superior vena cava syndrome include cancer (malignancies) and non-cancer (benign) conditions. The common forms of cancer that can cause the superior vena cava syndrome are lung cancer, lymphoma (cancer of the lymph nodes), and cancer that has spread (metastasis) to the chest, more commonly breast and testicular cancer. Non-cancer causes of the superior vena cava syndrome include infections (such as tuberculosis, fungus, and syphilis), benign tumors (such as teratomas, thymoma, dermoid cyst), aortic aneurysm, pericarditis, sarcoidosis, irradiation treatment to the chest, air in the chest (pneumothorax), and complication of central line catheters and congenital heart surgery.

The diagnosis of superior vena cava syndrome can be made with the typical findings above. The diagnosis is supported by identifying a cause for the superior vena cava syndrome, typically requiring X-ray imaging or CAT or MRI scanning.

The treatment of superior vena cava syndrome is directed toward the exact underlying cause. Therefore, treatment might include radiation treatment, antibiotics, chemotherapy, clot-busting (thrombolytic) drugs, blood thinners (anticoagulation), and balloon angioplasty, and even surgery.

The outlook for patients with the superior vena cava syndrome depends on the underlying cause.

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