Superior Vena Cava Syndrome, A Simple Guide To The Condition, Diagnosis, Treatment And Related Conditions

This book describes Superior Vena Cava Syndrome, Diagnosis and Treatment and Related DiseasesSVC syndrome is a constriction or obstruction of the superior vena cava (SVC), which is the second largest vein in the human body. The superior vena cava transports blood from the upper half of the body to the heart. Blockage of the superior vena cava (SVC) can be due to external pressure, involvement of the vessel by tumor tissue, or a blood clot blocking the lumen.
CausesSVC syndrome is an infrequent disorder. It is most often produced by cancer or a tumor in the mediastinumToday, the most frequent cause is superior mediastinal pressure linked with lung cancer (> 85%). SVC syndrome can also be produced by non-cancerous disorders that produce scarring.1. Histoplasmosis (fungal infection)2. Inflammation of a vein (thrombophlebitis)3. Lung infections (such as TB)Other causes of SVC blockage are:1.
Aortic aneurysm (a widening of the artery that leaves the heart)2. Blood clots in the SVC3. Constrictive pericarditis (tightening of the thin lining of the sac surrounding the heart)4. Effects of radiation therapy for certain medical conditions5. Enlargement of the thyroid gland (goiter)6. Catheters placed in the large veins of the upper arm and neckSymptomsSymptoms may start suddenly or gradually, and may worsen when the patient bends over or lies down.1.
Swelling around the eye2. Swelling of the face3. Swelling of the whites of the eyesThe swelling tend most likely be worse in the early morning hours and fade away by mid-morning. The most frequent symptoms are shortness of breath (dyspnea) and swelling of the face, neck, trunk, and arms. In adults, bronchogenic carcinoma was the most frequent cause of SVC obstructionIn children, the most frequent causes are T-cell acute lymphoblastic leukemia and non-Hodgkin's lymphomaOther probable symptoms are:1.
Decreased alertness2. Dizziness, fainting3. Headache4. Reddish face or cheeksSigns:1. Dilated veins over the arms, neck and anterior chest wall.2. Edema of the upper body, extremities and face.3. Severe respiratory distress. DiagnosisThe doctor will do a physical examination, which may reveal enlarged veins of the face, neck, and upper chest. Blood pressure is often elevated in the arms and low in the legs.
CXR, CT scan and MRI: may show a widened mediastinum or a mass on the right side of the chestBronchoscopy has a reported diagnostic result of >70%, whilst mediastinoscopy or mediastinotomy has a result of >90%. TreatmentThe purpose of treatment is to alleviate the obstruction. The placement of a stent (tube placed inside a blood vessel) to open up the SVCMedical1. Elevation of the head, and oxygen2.
Diuretics (water pills) or steroids (anti-inflammatory drugs)3. Radiation or chemotherapy or surgery to reduce the tumor4. Anticoagulation may be needed where venography has revealed central vein thrombosis, to prevent pulmonary embolismSurgicalStenting and angioplasty (also known as endovascular surgery) are particularly useful in patients requiring long-term venous accessReconstructive surgery is possible and may be helped by the use of autologous tissueThese treatments may be used for SVCS in children:1.
Radiation therapy if a tumor is blocking the vein2. Corticosteroids to reduce swelling3. Chemotherapy for treatment of tumor4 Stent placement to improve blood flow5. Surgery so blood can flow around the blocked part of the veinStenting should be considered first-line treatment for SVCS of benign origin, with open surgical reconstruction still a good choice if endovascular repair fails or is unsuitableTABLE OF CONTENTIntroductionChapter 1 Superior Vena Cava SyndromeChapter 2 CausesChapter 3 Sy...