Summary
Definition
History and exam
Key diagnostic factors
- history of smoking, pacemaker, or central venous catheter
- localized edema of the face and upper extremities
- dyspnea
- facial plethora
- cough
- distended neck veins
- distended chest veins
- hoarseness of voice
- lymphadenopathy
- blurred vision
- stridor
- confusion/stupor
Other diagnostic factors
- anorexia
- weight loss
- hemoptysis
- headache
- chest pain
- mental changes
- fever
- skin rash
- arthralgia
- laryngeal edema
- cyanosis
- papilledema
- coma
Risk factors
- smoking
- multiple pacemaker leads
- central venous catheters/ports
- age >50 years
- radiation
Diagnostic investigations
1st investigations to order
- chest x-ray
- chest CT
- chest MRI
- ultrasound of upper extremities
Investigations to consider
- venography
- biopsy
- sputum cytology
- thoracentesis
- sputum culture
- erythrocyte sedimentation rate
- C-reactive protein
Treatment algorithm
Contributors
Authors

Professor of Clinical Medicine
University of Missouri
Columbia
MO
Disclosures
KA declares that he has no competing interests.
Assistant Professor of Clinical Medicine
University of Missouri
Columbia
MO
Disclosures
AKC declares that he has no competing interests.
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
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.
Associate Professor
University of Texas MD Anderson Cancer Center
Department of Cardiology
Houston
TX
Disclosures
SWY declares that he has no competing interests.
Cardiology Specialist Registrar
The James Cook University Hospital
Middlesbrough
UK
Disclosures
AT declares that he has no competing interests.
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