Síndrome da veia cava superior
Summary
Definition
History and exam
Key diagnostic factors
- presença de fatores de risco
- edema localizado da face e dos membros superiores
- dispneia
- pletora facial
- tosse
- veias jugulares distendidas
- veias torácicas distendidas
- rouquidão
- linfadenopatia
- visão turva
- estridor
- confusão/letargia
Other diagnostic factors
- anorexia
- perda de peso
- hemoptise
- cefaleia
- dor torácica
- alterações mentais
- febre
- erupção cutânea
- artralgia
- edema laríngeo
- cianose
- papiledema
- coma
Risk factors
- tabagismo
- múltiplos eletrodos de marca-passos
- cateteres venosos centrais/porta
- idade >50 anos
- radiação
Diagnostic tests
1st tests to order
- radiografia torácica
- tomografia computadorizada (TC) do tórax
- ressonância nuclear magnética (RNM) do tórax
- ultrassonografia de membros superiores
Tests to consider
- venografia
- biópsia
- citologia do escarro
- toracocentese
- cultura de escarro
- velocidade de hemossedimentação
- proteína C-reativa
Treatment algorithm
obstrução aguda das vias aéreas (sem diagnóstico tecidual)
etiologia maligna
etiologia infecciosa
etiologia iatrogênica
Contributors
Authors
Kul Aggarwal, MD, MRCP, FACC
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.
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
- Tamponamento cardíaco
- Pericardite constritiva
- Exacerbação aguda da doença pulmonar obstrutiva crônica (DPOC)
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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