Superior vena cava syndrome

Last reviewed: 10 Jul 2022
Last updated: 09 Jul 2019

Summary

Definition

History and exam

Key diagnostic factors

  • presence of risk factors
  • localised oedema of the face and upper extremities
  • dyspnoea
  • facial plethora
  • cough
  • distended neck veins
  • distended chest veins
  • hoarseness of voice
  • lymphadenopathy
  • blurred vision
  • stridor
  • confusion/stupor
More key diagnostic factors

Other diagnostic factors

  • anorexia
  • weight loss
  • haemoptysis
  • headache
  • chest pain
  • mental changes
  • fever
  • skin rash
  • arthralgia
  • laryngeal oedema
  • cyanosis
  • papilloedema
  • coma
Other diagnostic factors

Risk factors

  • smoking
  • multiple pacemaker leads
  • central venous catheters/ports
  • age >50 years
  • radiation
More risk factors

Diagnostic investigations

1st investigations to order

  • chest x-ray
  • chest CT
  • chest MRI
  • ultrasound of upper extremities
More 1st investigations to order

Investigations to consider

  • venography
  • biopsy
  • sputum cytology
  • thoracentesis
  • sputum culture
  • erythrocyte sedimentation rate
  • C-reactive protein
More investigations to consider

Treatment algorithm

ACUTE

acute airway obstruction

ONGOING

malignant aetiology

infectious aetiology

iatrogenic aetiology

Contributors

Authors

Kul Aggarwal, MD, MRCP, FACC
Kul Aggarwal

Professor of Clinical Medicine

University of Missouri

Columbia

MO

Disclosures

KA declares that he has no competing interests.

Albert K. Chan, MD

Assistant Professor of Clinical Medicine

University of Missouri

Columbia

MO

Disclosures

AKC declares that he has no competing interests.

Acknowledgements

Professor Kul Aggarwal and Dr Albert K Chan would like to gratefully acknowledge Dr Nipun Arora and Lokesh Tejwani, previous contributors to this topic. NA declares that he has no competing interests.

Peer reviewers

Debabrata Mukherjee, MD

Gill Foundation Professor of Interventional Cardiology

Director of Cardiac Catheterization Laboratories

Gill Heart Institute

Division of Cardiovascular Medicine

University of Kentucky

Lexington

KY

Disclosures

DM declares that he has no competing interests.

Syed Wamique Yusuf, MD, MRCPI, FACC

Associate Professor

University of Texas MD Anderson Cancer Center

Department of Cardiology

Houston

TX

Disclosures

SWY declares that he has no competing interests.

Andrew Turley, MB ChB

Cardiology Specialist Registrar

The James Cook University Hospital

Middlesbrough

UK

Disclosures

AT declares that he has no competing interests.

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