Superior Vena Cava Syndrome

What is superior vena cava syndrome?

Superior vena cava syndrome (SVCS) is a group of symptoms that occurs when your superior vena cava is blocked or squeezed. Your superior vena cava is a blood vessel that returns blood from your upper body to your heart. When this vein is blocked, it can cause swelling in your upper body, shortness of breath and other symptoms. Severe cases that aren’t treated can be life-threatening, especially in children.

How common is superior vena cava syndrome?

SVCS isn’t common, but it’s becoming more common with the increased use of implanted medical devices. About 15,000 cases occur in the United States each year.

SVCS is more likely to happen in people with cancer and people who have implanted medical devices.

What is the most common cause of superior vena cava obstruction syndrome?

The most common cause of SVCS is cancer. A tumor can compress your vein, slowing or blocking blood flow back to your heart. This creates pressure in your upper body, leading to the symptoms of superior vena cava syndrome. Types of cancer associated with superior vena cava syndrome include lung cancer and non-Hodgkin lymphoma.

Other possible causes include an infection or blood clot near an implanted medical device. Examples include a pacemaker or intravascular catheter (tube placed in a blood vessel to deliver medication).

What are the signs and symptoms of superior vena cava syndrome?

Signs of superior vena cava syndrome usually develop slowly. But they can worsen quickly and turn into a medical emergency, especially in children. It’s essential to contact your healthcare provider if you or your child develops symptoms.

The most common superior vena cava syndrome symptoms include:

• Cough.
• Face or neck swelling.
• Feeling of fullness in your upper body.
• Swelling in your arms and hands.
• Shortness of breath (dyspnea).

Other signs sometimes include:

• Blueish skin (cyanosis).
• Chest pain.
• Coughing up blood.
• Faster breathing.
• Hoarse voice or difficulty speaking.
• Horner’s syndrome, symptoms on one side of your face (sagging eyelid, lack of sweat, one smaller pupil).
• Trouble swallowing.
• Visibly swollen veins in your upper body.

How is superior vena cava syndrome diagnosed?

If you have signs of SVCS, your healthcare provider may order tests to take pictures inside of your upper body. Imaging tests can show whether anything is pressing on your superior vena cava. Tests may include:

• Chest X-ray.
• CT scan.
• MRI.
• Ultrasound.
• Venogram, an X-ray of veins in your upper body after your healthcare provider injects dye into your bloodstream.

Your healthcare provider also may recommend blood tests or a biopsy to diagnose cancer.

What is the treatment for superior vena cava syndrome?

If blood flows well through other veins and you don’t have bothersome symptoms, you might not need immediate treatment.

But your healthcare provider should treat the underlying medical issue. For example, you may need:

• Antibiotics for infection.
• Blood thinners (anticoagulants) to break up a blood clot.
• Chemotherapy or radiation therapy for cancer.
• Repair, replacement or removal of a medical device.

If the condition is affecting blood flow or causing troubling symptoms, other superior vena cava syndrome treatment options include:

• Bronchodilators, which widen the airways to help you breathe (often used for asthma).
• Corticosteroids to reduce swelling.
• Diuretics (water pills), which lower blood pressure and help remove extra fluids from your body.
• Procedure to implant a stent, a tiny tube that can prop open your vein.
• Supplemental oxygen that you breathe through a mask or tubes up your nose.
• Surgery to reroute blood around your superior vena cava.

How can I prevent superior vena cava syndrome?

There aren’t any proven strategies to prevent SVCS.

What can I expect if I have superior vena cava syndrome?

Prognosis with superior vena cava syndrome varies widely, depending on its severity. Most people’s symptoms get much better quickly with treatment. But severe cases can cause life-threatening problems with breathing, especially in children.

The overall outlook often depends on the underlying condition, such as the type and stage of cancer.

Does superior vena cava syndrome usually return after treatment?

SVCS syndrome can recur (return) if the underlying cause isn’t treated. For example, corticosteroids can reduce swelling in your SVC from infection. But the underlying infection must be treated, or SVCS could come back.