Superior vena cava syndrome (SVCS) is a medical condition characterized by the compression or obstruction of the superior vena cava, which is one of the two main large veins that carry deoxygenated blood from the upper body to the heart. The syndrome occurs when a pathological process, such as a tumor or blood clot, exerts pressure on or obstructs the vessel, leading to impaired blood flow.
The most common cause of SVCS is the presence of a malignant tumor, especially lung cancer, in the mediastinum, which is the central region of the chest. Other potential causes include nonmalignant tumors, such as benign mediastinal tumors, lymphomas, or infections like tuberculosis.
The symptoms of SVCS arise as a consequence of impaired blood flow and may vary in severity. Common manifestations include facial and upper extremity swelling, distention of veins in the neck and upper chest, cough, shortness of breath, dizziness, and headache. In severe cases, patients may experience difficulty in swallowing and altered mental status due to reduced blood flow to the brain.
Diagnosis of SVCS usually consists of a thorough medical history, physical examination, and imaging studies such as chest X-rays, computed tomography (CT) scans, or magnetic resonance imaging (MRI). Treatment approaches depend on the underlying cause and severity of symptoms. They may include management of the primary tumor with chemotherapy, radiation therapy, or surgery, as well as measures to relieve symptoms such as diuretics to reduce fluid retention, corticosteroids to reduce swelling, and supportive care. In some cases, placement of a stent or surgical bypass may be necessary to restore proper blood flow in the superior vena cava.
