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Superior Vena Cava Syndrome

  • Maria ToliaEmail author
  • Nikolaos Tsoukalas
  • Ioannis Zerdes
  • Jiannis Hajiioannou
  • George Kyrgias
Chapter

Abstract

The superior vena cava syndrome (SVCS) involves a group of symptoms deriving from obstruction or compression of the superior vena cava. Malignant causes represents the majority of all cases of SVCS. Iatrogenic causes may be responsible for SVCS, considering the presence of intravascular devices. Infectious causes such as syphilis and tuberculosis have also been known to cause SVCS.

Conserning the clinical presentation of SVCS may be subacute or acute. The most typical presenting symptoms and signs are dyspnea, facial edema, jugular venous distention, upper body plethora, cough, orthopnea, stridor, chest pain, cyanosis, positive Pemberton’s sign, dysphagia, visual impairment, lethargy, and headache.

Diagnosis is obtained by the aid of chest X-ray, CT and MRI scans, venography, and nuclear flow studies. In addition to these, invasive methods, such as bronchoscopy, percutaneous needle biopsy, mediastinoscopy, and thoracotomy, can also be applied.

Several methods of treatment are available. Endovascular stenting by an interventional radiologist may provide potential relief of symptoms, in an acute setting with severe symptoms. In the case of SVCS deriving from non-small cell lung cancer and other metastatic solid tumors, radiotherapy is the main treatment. Chemotherapy is effective in small cell carcinoma of the lung, lymphoma, and germ cell tumor. Surgery is helpful for patients in whom a benign process is the cause. Glucocorticoids have an ambiguous effect, as they may be useful at lymphomas but with no benefit on lung cancer. Diuretics with a low-salt diet and head elevation may also be beneficial.

Keywords

Superior vena cava Syndrome Review 

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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Maria Tolia
    • 1
    Email author
  • Nikolaos Tsoukalas
    • 2
  • Ioannis Zerdes
    • 3
  • Jiannis Hajiioannou
    • 4
  • George Kyrgias
    • 1
  1. 1.Department of RadiotherapyUniversity of Thessaly, School of Health Sciences, Faculty of Medicine, BiopolisLarissaGreece
  2. 2.Oncology Clinic, 401 General Military HospitalAthensGreece
  3. 3.Faculty of Medicine, School of Health SciencesUniversity of IoanninaIoanninaGreece
  4. 4.Department of OtolaryngologyUniversity of Thessaly, School of Health Sciences, Faculty of Medicine, BiopolisLarissaGreece

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