Superior vena cava syndrome

Superior vena cava (SVC) syndrome is a clinical condition that occurs due to obstruction of the SVC.

The most common etiology is malignancy; however, there has been an increase in benign causes due to more frequent use of intravascular devices.

Although rarely fatal, it may sometimes present as life-threatening upper airway obstruction.

A high index of suspicion is required to make the diagnosis in many cases.

Treatment and prognosis depend on underlying etiology.

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. The increased venous pressure results in edema of the head, neck, and arms, often with cyanosis, plethora, and distended subcutaneous vessels.[1]Wilson LD, Detterbeck FC, Yahalom J. Clinical practice: superior vena cava syndrome with malignant causes. N Engl J Med. 2007 May 3;356(18):1862-9. http://www.ncbi.nlm.nih.gov/pubmed/17476012?tool=bestpractice.com [2]Azizi AH, Shafi I, Shah N, et al. Superior vena cava syndrome. JACC Cardiovasc Interv. 2020 Dec 28;13(24):2896-2910. https://www.sciencedirect.com/science/article/pii/S1936879820319725?via%3Dihub http://www.ncbi.nlm.nih.gov/pubmed/33357528?tool=bestpractice.com ​ It can be caused by either intraluminal obstruction of the SVC or extrinsic compression.