Superior Vena Cava Syndrome

Medically reviewed by Debra Sullivan, PhD, MSN, RN, CNE, COI on September 1, 2017Written by Becky Young on September 1, 2017

Overview

The superior vena cava is one of the primary veins within our bodies. It transports blood from our arms, chest, neck, and head to our hearts. In superior vena cava syndrome (SVCS), this vein has become obstructed or compressed to some degree. One of the main causes of SVCS is cancer.

What are the symptoms of superior vena cava syndrome?

SVCS usually results in a group of symptoms that develop slowly over time. If these symptoms are ignored, SVCS can cause serious breathing problems and become a medical emergency. So if you experience any of the common symptoms of SVCS you should seek medical advice immediately.

The common symptoms of SVCS are:

  • coughing
  • swollen arms, torso, neck, or face
  • trouble breathing and shortness of breath

There are some other symptoms of SVCS, but these occur more rarely. They are:

  • a hoarse throat
  • quicker respiration
  • chest pain
  • difficulty with swallowing
  • swollen veins in the chest and neck
  • coughing up blood
  • a blue tinge to the skin due to lack of oxygen
  • paralysis of the vocal chords
  • Horner’s syndrome, which includes a small pupil, drooping eyelid, and lack of perspiration on one side of your face

Symptoms in children

SVCS can be life-threatening for children because their airways are smaller and softer than those of adults. The symptoms in children are the same as for adults. But due to the more serious nature of the condition for children, it’s even more important that you seek medical help for them as soon as any of these symptoms are displayed.

Symptoms in pregnant women

Women in the latter stages of their pregnancy may experience a condition similar to SVCS called inferior vena cava syndrome. This occurs when the smaller vein transporting blood to the heart from the lower body gets compressed by the growing uterus. Pregnant women with inferior vena cava syndrome may experience lightheadedness and low blood pressure when they lie on their backs. Lying on their left side usually eases their symptoms.

What are the causes of this syndrome?

The majority of cases of SVCS are caused by cancer. It’s most common in people with lung cancer, non-Hodgkin’s lymphoma or any other cancer that has spread to the chest.

Tumors in the chest may press on or grow into the superior vena cava. If the cancer spreads to the lymph nodes around the superior vena cava, they can enlarge and press on or cause a blockage in the vein.

SVCS can also be caused by a blood clot in the vein. They are often caused by a pacemaker wire or an intravenous catheter, which is a flexible tube put into a vein to remove or add fluids.

What are the treatment options for superior vena cava syndrome?

People with SVCS don’t always need treatment right away. It will depend on how severe the symptoms are, whether or not their airway is blocked, and if the blood is flowing well through the other veins in their chest.

The main treatment for SVCS is to treat the cancer that is causing it with chemotherapy or radiotherapy.

However, other things can be done to alleviate the symptoms. Your doctor might prescribe corticosteroids to reduce swelling or diuretics to remove excess fluid from your body by increasing urination.

If the SVCS is caused by a blood clot, your doctor may recommend thrombolysis, a treatment to break up the clot within the vein, or that a stent be inserted to hold open the blocked vein. Surgery to bypass any blockages may also be an option.

Complications and associated conditions

If SVCS isn’t treated effectively, then ultimately it can lead to an inability to breathe, which can be fatal. SVCS is most commonly associated with cancers that occur in the chest area, but it has also been associated with syphilis and tuberculosis.

Outlook

Superior vena cava syndrome itself is very treatable, and symptoms are usually greatly improved within the first month of treatment. However, because the majority of cases are caused by cancer, the overall outlook will depend on the type and stage of the cancer involved.

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