Diagnostic Considerations
Important considerations
Consider the diagnosis of superior vena cava syndrome in patients with known lung cancer. Their symptoms of increasing shortness of breath may be from superior vena cava syndrome. Symptoms may be relieved with radiation therapy.
In patients in whom the diagnosis of lung cancer is not known, patients' sensations of arms swelling, facial fullness, and related symptoms may tend to be discounted. An excellent opportunity may exist to positively affect a patient's prognosis if the diagnosis of superior vena cava syndrome is entertained and the underlying cause of cancer is considered.
Another condition to consider in patients with suspected superior vena cava syndrome is airway obstruction.
Special concerns
Special concerns include the need to be sensitive to patients' probable diagnosis of lung cancer. [8] In patients in whom the diagnosis has not been made, this represents a unique occasion for the clinician to approach the patient with care. Special care must be taken to ensure that the explanation of the patient's symptoms is not rushed.
Differential Diagnoses
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Superior Vena Cava Syndrome in Emergency Medicine. Patient with a 4-week history of increasing facial edema and known lung cancer.
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Superior Vena Cava Syndrome in Emergency Medicine. Chest radiograph of a patient with known superior vena cava syndrome (SVCS) and bronchogenic carcinoma (CA).
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Superior Vena Cava Syndrome in Emergency Medicine. Chest radiograph of a 50-year-old woman with complaint of shortness of breath and facial swelling. No previous history of cancer but 30 pack-year history.
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Superior Vena Cava Syndrome in Emergency Medicine. CT scan of the same 50-year-old woman in the previous image with an initial presentation of shortness of breath and facial swelling. This shows a large tumor mass in the right mediastinum nearly surrounding the right main stem bronchus and partially occluding the superior vena cava.
