SVC obstruction

Alternative names

Superior vena cava obstruction; Superior vena cava syndrome

Definition

SVC obstruction is a narrowing or obstruction of the superior vena cava - the major vein draining the upper body.

Causes, incidence, and risk factors

Superior vena cava (SVC) obstruction is a relatively rare condition. Most often it is caused by one of several cancers that can be found in the mediastinum (the area of the chest under the breastbone and between the lungs).

These include lymphomas, cancer of the lung with extension into the mediastinum, Breast cancer, Testicular cancer, Thyroid cancer, and thymic tumors. Superior vena cava obstruction can also be caused by noncancerous conditions that cause chronic fibrosis (scarring).

These include lung infections, such as Tuberculosis, histoplasmosis infection, and thrombophlebitis (particularly extension of thrombophlebitis of superficial veins or the subclavian vein). Other causes of superior vena cava obstruction include aortic aneurysm, constrictive pericarditis, and goiter.

Symptoms

• neck swelling, facial swelling, or arm swelling
  
• swelling around the eye socket (periorbital)
  
• sensation of head or ear "fullness"
  
• reddish face or cheeks
  
• reddish palms
  
• reddish mucous membranes (inside the nose, mouth, and so on)
  
• redness changing to blueness later
  
• headache
  
• dizziness
  
• vision changes
  
• fainting
  
• decreased alertness
  

Note: Symptoms may begin suddenly or gradually, and may worsen when bending over or lying down.

Signs and tests

An examination may show dilated cutaneous (skin) veins of the face, neck, and upper chest. Blood pressure is often high in the arms and low in the legs.

A bronchoscopy may be performed if lung cancer is suspected.

Obstruction of the SVC may show on:

• Chest x-ray