Superior Vena Cava Syndrome Clinical Presentation

Updated: May 15, 2017
  • Author: Todd A Nickloes, DO, FACOS; Chief Editor: Vincent Lopez Rowe, MD  more...
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Presentation

History

Early in the clinical course of superior vena cava syndrome (SVCS), partial obstruction of the superior vena cava (SVC) may be asymptomatic, but more often, minor symptoms and signs are overlooked.

As the syndrome advances toward total SVC obstruction, the classic symptoms and signs become more obvious. Dyspnea is the most common symptom, observed in 63% of patients with SVCS. [6, 19] Other symptoms include facial swelling, head fullness, cough, arm swelling, chest pain, dysphagia, orthopnea, distorted vision, hoarseness, stridor, headache, nasal stuffiness, nausea, pleural effusions, and light-headedness. [6, 19, 20]

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Physical Examination

The characteristic physical findings of SVCS include venous distention of the neck and chest wall, facial edema, upper-extremity edema, mental changes, plethora, cyanosis, papilledema, stupor, and even coma. Bending forward or lying down may aggravate the symptoms and signs.

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Complications

Complications of SVCS may include the following:

  • Laryngeal edema
  • Cerebral edema
  • Decreased cardiac output with hypotension
  • Pulmonary embolism (when an associated thrombus is present)
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