Superior Vena Cava Syndrome Information

Superior Vena Cava Syndrome Health Article

By Molly Metzler R.N., B.S.N.The Gale Group Inc., Gale…more »

Definition

The superior vena cava is a large vein in the chest that drains the blood from the upper body back to the heart. Compression or occlusion (blocking off) of this vein creates superior vena cava syndrome.

Description

When the superior vena cava (SVC) becomes compressed or occluded, the blood from the upper body cannot drain back to the heart properly. This creates suffusion (the spreading of bodily fluids into surrounding tissue) which causes varying degrees of airway obstruction, swelling and cyanosis (purple discoloration due to lack of oxygenation) of the face, neck, arms and chest area. Patients with superior vena cava syndrome (SVC syndrome) might experience facial swelling causing the shirt collar to feel tight, shortness of breath, coughing, a change of voice, or confusion. A patient might also notice distention or enlargement of veins near the surface of the skin. The development of these signs and symptoms is usually a gradual process taking up to four weeks from onset of symptoms to diagnosis.

Causes and diagnosis

Cancer is the most common cause of superior vena cava syndrome. Lung cancer, lymphoma, breast cancer, and germ cell tumors of the chest are commonly associated with SVC syndrome. Any cancer that invades or constricts the blood vessels in the chest can cause SVC syndrome. Other non-cancer causes of SVC Syndrome are thyroid goiter, fungal infections, pericardial constriction, aortic aneurysm, and any other disease that creates swelling in the mediastinum (organs and vessels of the chest). Occasionally, SVC syndrome can be caused by a central vein catheter (an IV catheter that is placed into central circulation with its tip in the superior vena cava), which may cause a thrombosis (blockage) of the SVC.

The physician diagnoses SVC syndrome by starting with a complete patient history and physical examination. The physician will ask about onset of symptoms and timeframes of symptom development. The physician will recommend a chest x ray and a CT scan to visualize the chest area in order to confirm the presence of SVC syndrome. The physician may also order venous patency (flow of blood through the vein) studies using contrast dye and scanning techniques. The physician may order a scan done in a MRI lab (magnetic resonance imaging), ultrasound lab, or in nuclear medicine to help assess the cause of the superior vena cava syndrome. These tests help the physician identify the site and nature of the obstruction. If cancer of the bronchi is suspected, the patient should also anticipate other testing such as sputum collection, bronchoscopy, and biopsy of the suspected cancer site. These tests are very important to the oncologist (a physician who specializes in the treatment of cancer), because they will help to identify the disease, determine the stage, and hence the appropriate course of treatment.