Fact-sheet: Superior vena cava syndrome
Updated on 08/29/2017 at 3:37 PM
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Definition
Groups the secondary signs related to superior vena cava obstruction and increased pressure in the upstream circulation
Clinical features
Cough
Pelerine, cervicofacial and eyelid edema
Facial cyanosis, dyspnea, occasionally dysphonia
Jugular venous distension, thoracic collateral venous circulation
Headaches
Laboratory findings
CBC, coagulation workup, renal function, calcemia
D-dimers unnecessary
Radiography
Widening of the superior mediastinum
Filling in of the aortopulmonary window
Visualization of the causative lesion
CT
Visualization of venous collateral pathways:
- Azygos and hemiazygos system
- Internal mammary vein
- Lateral thoracic and superficial thoracoabdominal veins
- Perispinal venous plexus
Visualization of superior vena cava obstruction
Malignant or benign causative lesion
Management
Medical
+/- oncologic treatment
Endovascular treatment: Intraluminal angioplasty and stents
Classification
4 types of superior vena cava obstruction
type 1: partial obstruction (
type 2: obstruction greater than 90% with functional azygos return
type 3: obstruction greater than 90% with nonfunctional azygos return
type 4: complete obstruction involving at least one of the venous trunks forming the SVC, and the azygos system