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. Its affection of the superior vena cava is rather rare with only a few cases described in the literature. A reassessment of the clinical applications of the superior vena cava syndrome. Tumors, blood clots and thrombus in the mediastinum can cause compression. 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. Symptoms of the syndrome include shortness of breath. I was diagnosed with this at the same time as my lung tumor. Superior vena cava syndrome discharge care what you.
Clarkepearson md, in clinical gynecologic oncology ninth edition, 2018. Superior vena cava syndrome affects 15,000 patients each year in the united states, and its incidence continues to grow as the prevalence of intravascular devices increases. For a few, superior vena cava syndrome svc syndrome will be the. A 42yearold male patient was seen at consultation presenting with a pulsatile, warm and slightly. William hunter first described the syndrome in 1757 in a patient with syphilitic aortic aneurysm. Svcs develops in 510% of patients with a rightside malignant intrathoracic mass lesion. 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. A transthoracic needle biopsy showed a nonsmallcell carcinoma. Congenital or acquired abnormalities can affect the. Superior vena cava and the azygos system clinical anatomy svc. Superior vena cava syndrome is diagnosed by ultrasound, chest xray, ct scan, and in some cases biopsy. A patient with svcs requires immediate diagnostic evaluation and therapy. Review of evolving etiologies, implications and treatment. The anterior vena cava, also known as the precava, drains the head end of the body, while the posterior vena cava, or postcava, drains the tail, or rear, end.
Sep 15, 20 cancer can cause superior vena cava syndrome. 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. The diagnosis can be made clinically, but imaging studies are recommended for confirmation. Primary or metastatic cancer in the upper lobe of the right lung can compress the superior vena cava. The syndrome is rarely an oncologic emergency in the absence of tracheal compression and airway compromise. Description superior vena cava syndrome is a partial occlusion of the.
Superior vena cava syndrome causes, symptoms, treatment. Superior vena cava syndrome occurs when the superior vena cava becomes blocked. It transports blood from our arms, chest, neck, and head to our hearts. Superior vena cava syndrome svcs is rare in childhood. Sep 01, 2017 the superior vena cava is one of the primary veins within our bodies. Superior vena cava syndrome is a group of symptoms caused by obstruction of the superior vena cava.
Superior vena cava syndrome svcs is the clinical manifestation of superior vena cava svc obstruction, with severe reduction in venous return from the head. Superior vena cava obstruction evaluation with mdct. Treatment should also be individualized and should not be undertaken until a. Superior vena cava syndrome discharge care what you need. 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 svcs refers to the clinical syndrome with symptoms that results from this obstruction. The most common cause of superior vena cava syndrome is cancer. Superior vena cava syndrome svcs superior mediastinal syndrome sms the svc is a thin walled vessel which is easily compressed by tumors or infection arising in adjacent lymph nodes and thymus. The superior vena cava is one of the primary veins within our bodies. It can occur as a side effect of pacemaker wiring or dialysis procedure and usage of intravenous catheters. It is most often caused by cancer or a tumor in the mediastinum the area of the chest under the. After his recurrence in may, my father has been diagnosed with superior vena cava syndrome and it turns out that this is the reason why his.
Management of the superior vena cava syndrome associated with malignant conditions involves both treatment of the cancer and relief of the symptoms of obstruction the median life expectancy among patients with obstruction of the superior vena cava is approximately 6 months. Superior vena cava svc syndrome occurs in approximately 15,000 people in the united states each year. Superior vena cava syndrome superior vena cava obstruction. Whereas many mammals, including humans, have only one anterior vena cava, other animals have two. Vena cava, in airbreathing vertebrates, including humans, either of two major trunks, the anterior and posterior venae cavae, that deliver oxygendepleted blood to the right side of the heart. William hunter first described the syndrome in 1757 in. Superior vena cava syndrome is a form of vessel obstruction that occurs as a result of mechanical compression or due to thrombosis. Superior vena cava svc syndrome has a characteristic and often striking. Streiff md, in consultative hemostasis and thrombosis fourth edition, 2019. Treatment should also be individualized and should not be undertaken until a diagnosis is obtained. The syndrome was originally described as being secondary to an infection, such as tuberculosis, or a syphilitic aortic aneurysm 24.
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. In humans these veins are respectively called the superior and inferior venae cavae. A clot was surgically removed from the left subclavian vein. Superior vena cava syndrome an overview sciencedirect topics. The superior vena cava is the large vein that carries blood from the head, neck, arms and chest to the heart. Washington university, 1987 pmid 3558044 role of irradiation in the management of superior vena cava syndrome. Superior vena cava syndrome svcs is a medical condition which consists of the obstruction of blood flow through the superior vena cava. It is a largediameter 24 mm short length vein that receives venous return from the upper half of the body, above the diaphragm.
Full text of superior vena cava syndrome in the cancer patient. The superior vena cava svc is a large valveless venous channel formed by the union of the brachiocephalic veins. A cancerrelated medical emergency more pulmccm topic updates multiple cancers are expected to rise in prevalence in the u. Superior vena cava and the azygos system clinical anatomy svc obstruction oncology emergency. Causes of superior vena cava include lung cancer, lymphoma, other cancers in the chest, blood clots in the superior vena cava, or. Radiation oncologypalliationsvc syndrome wikibooks, open. Superior vena cava syndrome svcs develops when your superior vena cava is partially or fully blocked. Malignancies are the main cause and are considered an oncologic emergency.
Venous return from the lower half, below the diaphragm, flows through the. A case study elaine kinnard, msn, cnp from licking memorial health systems, newark, ohio authors disclosures of potential conflict of interest are found at the end of this article. Radiotherapy resulted in clinical improvement and a rapid reduction in compression of the 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 overview of the risk factors, pathology, and clinical manifestations of lung cancer view in chinese. Currently, svc syndrome is generally due to cancer or thrombotic events. The exact incidence of superior vena cava syndrome remains unknown, it has mainly malignant causes. Lung cancer is the most common cause of superior vena cava syndrome svcs and requires timely recognition and management.
Appropriate imaging techniques are important to confirm the diagnosis and rule out other causes of svc syndrome. Superior vena cava syndrome svcs is a medical emergency which consists of the obstruction of blood flow through the superior vena cava. Svcs is a significant disorder affecting up to 10 % of small cell lung cancer sclc patients and 24 % of all lung cancer patients. The clinical diagnosis of svc syndrome is based largely on history and physical examination. 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 moves blood from the upper half of the body to the heart. Management of the superior vena cava syndrome associated with malignant conditions involves both treatment of the cancer and relief of the symptoms of obstruction. Superior vena cava obstruction radiology reference article. Superior vena cava syndrome svcs is obstruction of blood flow through the superior vena cava svc. She was asymptomatic until six months before admission when she developed pain and swelling in the face and both upper. She was asymptomatic until six months before admission when she developed pain and swelling in the face and both upper extremities, at which time she was treated with chlorothiazide diuril.
Superior vena cava syndrome canadian cancer society. Blood from your upper body normally flows through the superior vena cava and into the right side of your heart. A restriction of the blood flow occlusion through this vein can cause superior vena cava syndrome svcs. It receives blood from the upper half of the body except the heart and returns it to the right atrium. Superior vena cava syndrome in children springerlink. Full text of superior vena cava syndrome in the cancer. Overview of svc syndrome including pathophysiology, anatomy, symptoms, and management. See other formats grand rounds superior vena cava syndrome in the cancer patient. Dan clair speaks on superior vena cava svc syndrome expert venous management 2017 duration. A 41yearold woman was admitted five years ago with pain and swelling in the left arm. Superior vena cava syndrome definition of superior vena. For a few, superior vena cava syndrome svc syndrome will. Superior vena cava svc obstruction can occur from extrinsic compression, intrinsic stenosis, or thrombosis.
Symptoms include facial edema, dyspnea, cough, neck distension, hoarseness and dysphagia, while severe cases may present with coma and severe respiratory distress. See more ideas about anatomy and physiology, cardiac nursing and heart anatomy. Any type of cancer like lymphoma, metastatic cancer can compress the veins of superior vena cava. Blood vessels major aorta azygos vein pulmonary artery or vein superior vena cava svc syndrome carina from lung compression of esophagus or trachea not specified as direct extension esophagus mediastinum, extrapulmonary or nos nerves cervical sympathetic horners syndrome recurrent laryngeal vocal cord paralysis. 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. The superior vena cava begins behind the lower border.
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. Primary tumors are most commonly the cause of this syndrome. Collateral pathways in superior vena cava obstruction as seen on gamma br j radiol 1982. Svc obstruction is a narrowing or blockage of the superior vena cava svc, which is the second largest vein in the human body. In superior vena cava syndrome svcs, this vein has. Superior vena cava svc syndrome is the result of stenosis or occlusion of the svc or bilateral brachiocephalic veins. Superior vena cava syndrome svc syndrome superior vena cava syndrome svc syndrome. What is the prevalence of superior vena cava syndrome svcs. Once the thoracic imaging is obtained, the workup should include brain, abdominal and bone studies in view of the probable malignant nature of the primary lesion.
May 09, 2020 a case study of a patient who developed superior vena cava syndrome following radiofrequency ablation of the sinoatrial and atrioventricular nodes, and pacemaker implantation. Introduction superior vena cava syndrome svcs is obstruction of blood flow through the superior vena cava svc. An ebook reader can be a software application for use on a computer such as microsofts free reader application, or a booksized computer this is used solely as a reading device such as nuvomedias rocket ebook. 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. Radiation oncologypalliationsvc syndrome wikibooks. 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. Superior vena cava syndromea proposed classification system. Superior vena cava obstruction presenting with epistaxis, haemoptysis and gastro. 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. Vascular thrombosis, especially venous, is common in this condition and also constitutes a basic diagnostic criterion. It carries low oxygen blood from the upper part of the body to the right atrium of the heart. Mar 27, 2020 superior vena cava syndrome svcs is obstruction of blood flow through the superior vena cava svc.
A case study of a patient who developed superior vena cava syndrome following radiofrequency ablation of the sinoatrial and atrioventricular nodes, and pacemaker implantation. Svcs is caused by compression, obstruction or thrombosis of superior vena cava. The median life expectancy among patients with obstruction of the superior vena cava is approximately 6 months. Oncologic emergencies harrisons principles of internal medicine. Dialysis accessinduced superior vena cava syndrome. The superior vena cava syndrome is the group of symptoms that result from compression of the large vein superior vena cava that transmits blood to the heart. The majority of cases are caused by malignant tumors within the mediastinum, most commonly lung cancer and nonhodgkins lymphoma, directly compressing or invading. Superior vena cava syndrome is a condition where blood flow through one of the major veins to the right side of the heart is blocked. It is a medical emergency and most often manifests in patients with a malignant disease process within the thorax. Treatment depends on the etiology of the obstructive process. It was first described by william hunter in 1757, in a patient with a large syphilitic aortic aneurysm compressing the svc3,5. Yale thoracic oncology program, yale cancer center and the department. The presence of these collateral vessels is an important ancillary ct finding of superior vena cava syndrome, with a sensitivity of 96% and a specificity of 92% 4. Superior vena cava syndrome an overview sciencedirect.