Superior vena cava syndrome

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**Superior vena cava syndrome**
*Classifications and external resources*
ICD-10	I 87.1
ICD-9	459.2
DiseasesDB	12711
MedlinePlus	001097
eMedicine	emerg/561

Superior vena cava syndrome (SVCS) is a result of obstruction of the superior vena cava. It is a medical emergency and requires immediate diagnosis and treatment.

1 Superior Vena Cava Syndrome
2 Symptoms
3 Causes
4 See also

[edit] Superior Vena Cava Syndrome

This syndrome can be immediately life-threatening as mentioned above. However, it usually presents more gradually, with an increase in symptoms over time. (Reference: http://www.emedicine.com/emerg/topic561.htm)

Approximately 90% of cases are associated with a cancerous tumor that is compressing the superior vena cava. Syphilis and tuberculosis have also been known to cause superior vena cava syndrome. For more information on infectious causes of superior vena cava syndrome, see the syphilis and tuberculosis (if there isn't a section to superior vena cava syndrome there already, it'll be added sooner or later).

Without treatment, most patients are dead within a month, and even with treatment, 90% die within two and a half years. This relates to the cancerous causes of SVC that are 90% of the cases.

The average age of onset of disease is 54 years of age.

An x-ray usually shows a mediastinal mass (tumor) that is compressing the superior vena cava.

[edit] Symptoms

Dyspnea
Flushed edematous face
Central nervous system symptoms like headache, visual symptoms, altered mentation.

Signs and symptoms include: facial and arm edema, fullness feeling in the head, dyspnea, tachypnea, difficulty swallowing, venous distension, cyanosis

Orthopnea
Nasal stuffiness
light-headedness

SVCS can cause - venous distension, airway obstruction, decrease cardiac filling and output, and increase likelihood of cerebral edema

[edit] Causes

It can be caused by invasion or compression by a pathological process or by thrombosis in the vein itself.

Before antibiotics, untreated infections were the most common cause of SVCS. Now malignacies (in particular, lung cancer) cause most SVCS's.

Common cancers that cause SVCS includes: Burkitt lymphoma, lymphoblastic lymphomas, acute lymphoblastic leukemia, and other acute leukemia

Diagnosis : chest x ray, ct scan of head and neck, tissue biopsy,and venography

Treatment modalities include: Chemo, radiation, thrombolytics, anti-coagulants, stent placement, and catheter replacements and surgery to remove the blockage.