Vena Cava

What is the vena cava?

The superior vena cava and inferior vena cava are very large veins that bring deoxygenated blood to your heart to get oxygen. Your inferior vena cava, your body’s largest vein, carries oxygen-depleted blood back to your heart from the lower part of your body (below your diaphragm). Your superior vena cava, your second biggest vein, brings oxygen-poor blood from your upper body to your heart.

Think of it like a bus line. The downtown line is like the smaller veins from your lower body (such as veins from your kidneys, liver and lower back area) that bring deoxygenated blood into your inferior vena cava. Blood from those other veins gets on the inferior vena cava bus to go to your heart.

Your uptown line (upper body) veins, such as the veins in your upper back and chest, take deoxygenated blood onto your superior vena cava bus for return to your heart. Your heart is the hub or destination where all the deoxygenated blood from the uptown and downtown bus lines (veins) goes.

What does the vena cava do?

Your superior vena cava and inferior vena cava have the important function of carrying oxygen-poor blood to your heart’s right atrium, where it moves into your right ventricle and then to your lungs (through your pulmonary artery) to trade in carbon dioxide for oxygen. Oxygenated blood comes back through your pulmonary veins to your heart’s left atrium. From there, blood that now carries fresh oxygen goes to your left ventricle and to your aorta for distribution to your body.

Where is the vena cava located?

Your inferior vena cava and superior vena cava are both on your heart’s right side. Your right and left innominate (or brachiocephalic) veins merge to form your superior vena cava.

Your superior vena cava is next to the right side of your sternum and goes into your right atrium, where all the oxygen-poor blood goes. Your inferior vena cava is a little longer. It starts where the right and left common iliac veins come together in your belly area and goes up into the right atrium of your heart.

What does the vena cava look like?

Your superior vena cava is a large vein that doesn’t have a valve.

Your inferior vena cava is a large and long vein that has one valve where it meets your right atrium.

How big is the vena cava?

These are your body’s largest veins. Your superior vena cava is 7 centimeters long (almost 3 inches) and 2 centimeters (less than 1 inch) wide.

Your inferior vena cava is about 100 millimeters (4 inches) long and 22 millimeters (less than 1 inch) in diameter.

What is it made of?

Your superior vena cava and inferior vena cava include:

• Endothelial cells (manage nutrient exchange with tissues).
• Connective (supporting) tissue.
• Nerve fibers.
• Elastic fibers.
• Muscle tissue.

What are the common conditions and disorders that affect the vena cava?

You can get an obstruction in your superior vena cava and inferior vena cava that makes it hard for blood to flow through them. When this happens, you can also call it superior vena cava syndrome or inferior vena cava syndrome, depending on which part of the vena cava has a blockage.

Causes of these obstructions include:

• A tumor, like lung cancer or another type of cancer, that has spread.
• Blood clots, sometimes from central venous catheters or pacemakers in the superior vena cava.
• A congenital malformation (something that didn’t form right in the uterus).

Common signs or symptoms of vena cava conditions

When something is pushing against your superior vena cava or inferior vena cava or blocking blood flow inside them, these symptoms can happen:

Superior vena cava syndrome (obstruction or compression) symptoms

• Swelling in your upper body.
• Shortness of breath.
• Angina.

Symptoms of a blood clot or tumor in your superior vena cava

• Upper body swelling.
• Shortness of breath.

Inferior vena cava blood clot symptoms

• Swelling in your legs.
• Back pain.
• Weight gain.
• Severe leg pain.

Inferior vena cava tumor symptoms

• Pain in your abdomen.
• Leg swelling.
• Weight loss.

Inferior vena cava syndrome (obstruction or compression) symptoms

• Low blood pressure.
• Swelling in your lower body.
• Tachycardia (fast heart rhythm).

Common tests to check the health of the vena cava

Your healthcare provider has several ways to get images of your superior vena cava and inferior vena cava, including:

• Chest X-ray (for your superior vena cava).
• Coronary angiography (for your superior vena cava).
• Ultrasound.
• CT (computed tomography).
• MRI (magnetic resonance imaging).
• Contrast venography or phlebography (rarely used X-ray of your veins).

Common treatments for the vena cava

Your healthcare provider can use similar treatments for problems with your superior vena cava and inferior vena cava. They can:

• Prescribe diuretics or steroids to treat swelling.
• Give you steroids, thrombolytics and anticoagulants to treat obstructions such as blood clots.
• Use a catheter to remove a blood clot.
• Do angioplasty (forcing the blockage to the vein wall) and put in a stent (small metal tube) to treat stenosis (narrowing) from a blood clot.
• Do bypass surgery for a blood clot or tumor.
• Do surgery to remove a tumor.
• Give you chemotherapy or radiation to treat tumors.

If you have a deep vein thrombosis (DVT) with a risk of the blood clot going from your legs or pelvis to your lung (pulmonary embolism), your healthcare provider may put in a vena cava filter to catch blood clots and keep them from going to your lungs.

Tips to keep your vena cava healthy

You can care for your vena cava like you care for the rest of the many blood vessels you have in your body.

• Eat a healthy diet that’s low in saturated fat.
• Exercise.
• Keep your stress level down.
• Manage conditions like high blood pressure, high cholesterol and diabetes.

A note from Cleveland Clinic

If you have an obstruction in your superior vena cava or inferior vena cava, your healthcare provider has a number of options to treat it. Talk to them about which treatment is best for your situation. If they prescribe medicines, be sure to keep taking them according to the instructions. Go to all of your follow-up appointments to ensure a good recovery from any procedures you may have.