Superior vena cava syndrome
小结
定义
病史和体格检查
关键诊断因素
- 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
其他诊断因素
- anorexia
- weight loss
- hemoptysis
- headache
- chest pain
- mental changes
- fever
- skin rash
- arthralgia
- laryngeal edema
- cyanosis
- papilledema
- coma
危险因素
- smoking
- multiple pacemaker leads
- central venous catheters/ports
- age >50 years
- radiation
诊断性检查
首要检查
- chest x-ray
- chest CT
- chest MRI
- ultrasound of upper extremities
需考虑的检查
- venography
- biopsy
- sputum cytology
- thoracentesis
- sputum culture
- erythrocyte sedimentation rate
- C-reactive protein
治疗流程
acute airway obstruction (without tissue diagnosis)
malignant etiology
infectious etiology
iatrogenic etiology
撰稿人
作者
Kul Aggarwal, MD, MRCP, FACC
Professor of Clinical Medicine
University of Missouri
Columbia
MO
利益声明
KA declares that he has no competing interests.
Albert K. Chan, MD
Assistant Professor of Clinical Medicine
University of Missouri
Columbia
MO
利益声明
AKC declares that he has no competing interests.
鸣谢
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.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
References
Key articles
Azizi AH, Shafi I, Shah N, et al. Superior vena cava syndrome. JACC Cardiovasc Interv. 2020 Dec 28;13(24):2896-2910.Full text Abstract
American College of Radiology. ACR appropriateness criteria: suspected upper-extremity deep vein thrombosis. 2019 [internet publication].Full text
Uberoi R. Quality assurance guidelines for superior vena cava stenting in malignant disease. Cardiovasc Intervent Radiol. 2006 May-Jun;29(3):319-22. Abstract
Kearon C, Akl EA, Ornelas J, et al. Antithrombotic therapy for VTE disease: CHEST guideline and expert panel report. Chest. 2016 Feb;149(2):315-52.Full text Abstract
Reference articles
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
Differentials
- Cardiac tamponade
- Constrictive pericarditis
- Acute COPD exacerbation
More DifferentialsGuidelines
- ACR Appropriateness Criteria: suspected upper-extremity deep vein thrombosis
- Antithrombotic therapy for VTE disease: CHEST guideline and expert panel report
More Guidelines
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