St. Luke's Hospital
Main Number: 314-434-1500 Emergency Dept: 314-205-6990 Patient Billing: 888-924-9200
Find a Physician Payment Options Locations & Directions
Follow us on: facebook twitter Mobile Email Page Email Page Print Page Print Page Increase Font Size Decrease Font Size Font Size
America's 50 Best Hospitals
Meet the Doctor
Spirit of Women
Community Health Needs Assessment
Home > Health Information

Multimedia Encyclopedia

    Print-Friendly
    Bookmarks

    SVC obstruction

    Superior vena cava obstruction; Superior vena cava syndrome

    SVC obstruction is a narrowing or blockage of the superior vena cava -- the second largest vein in the human body. The superior vena cava moves blood from the upper half of the body to the heart.

    Causes

    Superior vena cava (SVC) obstruction is a relatively rare condition.

    Most often it is caused by cancer or a tumor in the mediastinum (the area of the chest under the breastbone and between the lungs).

    The types of cancer that can lead to this condition include:

    • Breast cancer
    • Lymphoma
    • Metastatic lung cancer (lung cancer that spreads)
    • Testicular cancer
    • Thyroid cancer
    • Thymus tumors

    Superior vena cava obstruction can also be caused by noncancerous conditions that cause scarring. These conditions include:

    • Histoplasmosis infection
    • Inflammation of a vein ( thrombophlebitis)
    • Lung infections (such as tuberculosis)

    Other causes of superior vena cava obstruction include:

    • Aortic aneurysm (widening of the artery that leaves the heart)
    • Blood clots in the superior vena cava
    • Constrictive pericarditis (tightening of the thin lining of the heart)
    • Effects of radiation therapy for certain medical conditions
    • Enlargement of the thyroid gland (goiter)

    Catheters placed in the large veins of the upper arm and neck may cause blood clots in the superior vena cava.

    Symptoms

    Symptoms occur when something blocks the blood flowing back to the heart. They may begin suddenly or gradually, and may worsen when you bend over or lie down.

    Early signs include:

    • Swelling around the eye
    • Swelling of the face
    • Swelling of the whites of the eyes

    The swelling will most likely be worse in the early morning hours and go away by mid morning.

    The most common symptoms are shortness of breath (dyspnea) and swelling of the face, neck, trunk, and arms.

    Other possible symptoms include:

    • Decreased alertness
    • Dizziness
    • Fainting
    • Headache
    • Reddish face or cheeks
    • Reddish palms
    • Reddish mucus membranes (inside the nose, mouth, and other places)
    • Redness changing to blueness later
    • Sensation of head or ear "fullness"
    • Vision changes

    Exams and Tests

    An examination may show enlarged veins of the face, neck, and upper chest. Blood pressure is often high in the arms and low in the legs.

    A bronchoscopy (a lighted tube placed through the mouth into the windpipe and lungs) may be performed if lung cancer is suspected.

    Blockage of the SVC may be visible on:

    • Chest x-ray
    • CT scan of the chest or MRI of chest
    • Coronary angiography (a heart blood vessel study)
    • Doppler ultrasound (sound wave test of the blood vessels)
    • Radionuclide ventriculography (nuclear study of heart motion)

    This disease may also affect the results of the following tests:

    • Abdominal MRI or CT scan
    • Liver scan

    Treatment

    The goal of treatment is to relieve the blockage.

    Diuretics (water pills) or steroids may be used to relieve swelling.

    Other treatment options may include radiation or chemotherapy to shrink the tumor, or surgery to remove the tumors. Surgery to bypass the obstruction is rarely performed. Placement of a stent to open up the SVC is available at some medical centers.

    Outlook (Prognosis)

    The outcome varies depending on the cause and the amount of blockage.

    SVC syndrome caused by a tumor is a sign that the tumor has spread, and it indicates a poorer long-term outlook.

    Possible Complications

    The throat could become blocked, which can block the airways.

    Increased pressure may develop in the brain, leading to changed levels of consciousness, nausea, vomiting, or vision changes.

    When to Contact a Medical Professional

    Call your health care provider if you develop symptoms of SVC obstruction. Complications are serious and can sometimes be fatal.

    Prevention

    Prompt treatment of other medical disorders may reduce the risk of developing SVC obstruction.

    References

    Rice TW, Rodriguez MR, Light RW. The superior vena cava syndrome: clinical characteristics and evolving etiology. Medicine (Baltimore). 2006;85;1:37-42.

    Wilson LD, Detterbeck FC, Yahalom J. Superior vena cava syndrome with malignant causes. N Engl J Med. 2007;356:1862-1869.

    Ugras-Rey S, Watson M. Selected oncologic emergencies. In: Marx JA, Hockberger RS, Walls RM, et al, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 7th ed. Philadelphia, Pa: Mosby Elsevier;2009:chap 121.

    BACK TO TOP

    • Heart, section through t...

      illustration

      • Heart, section through t...

        illustration

      Tests for SVC obstruction

        Review Date: 1/1/2013

        Reviewed By: Jacob L. Heller, MD, MHA, Emergency Medicine, Virginia Mason Medical Center, Seattle, Washington. Also reviewed by A.D.A.M. Health Solutions, Ebix, Inc., Editorial Team: David Zieve, MD, MHA, David R. Eltz, Stephanie Slon, and Nissi Wang.

        The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
        adam.com

        A.D.A.M. content is best viewed in IE9 or above, Fire Fox and chrome browser.


        Back  |  Top
        About Us
        Contact Us
        History
        Mission
        Locations & Directions
        Quality Reports
        Annual Reports
        Honors & Awards
        Community Health Needs
        Assessment

        Newsroom
        Services
        Brain & Spine
        Cancer
        Heart
        Maternity
        Orthopedics
        Pulmonary
        Sleep Medicine
        Urgent Care
        Women's Services
        All Services
        Patients & Visitors
        Locations & Directions
        Find a Physician
        Tour St. Luke's
        Patient & Visitor Information
        Contact Us
        Payment Options
        Financial Assistance
        Send a Card
        Mammogram Appointments
        Health Tools
        My Personal Health
        mystlukes
        Spirit of Women
        Health Information & Tools
        Clinical Trials
        Health Risk Assessments
        Employer Programs -
        Passport to Wellness

        Classes & Events
        Classes & Events
        Spirit of Women
        Donate & Volunteer
        Giving Opportunities
        Volunteer
        Physicians & Employees
        For Physicians
        Remote Access
        Medical Residency Information
        Pharmacy Residency Information
        Physician CPOE Training
        Careers
        Careers
        St. Luke's Hospital - 232 South Woods Mill Road - Chesterfield, MO 63017 Main Number: 314-434-1500 Emergency Dept: 314-205-6990 Patient Billing: 888-924-9200
        Copyright © St. Luke's Hospital Website Terms and Conditions  |  Privacy Policy  |  Patient Notice of Privacy Policies PDF Sitemap St. Luke's Mobile