Superior Vena Cava (SVC) Syndrome
Superior Vena Cava (SVC) Syndrome: an urgent syndrome that unless recognized and treated will cause unnecessary suffering for the patient and the family as the physical appearance and symptoms may cause anxiety and distress.
SVC Obstruction
The SVC is the major vessel that drains the blood from the head, neck, upper extremities and thorax to the right atrium of the heart.
SVC Obstructions are commonly due to:
- Primary or metastatic tumor of the mediastinum
- Tracheal malignancies that invade the airway epithelium (squamous cell carcinoma and adenoid cystic carcinoma)
- Lymphoma and locally advanced thyroid, lung or esophageal cancers.
- Thrombosis of superior vena cava from indwelling intracaval catheters and central – venous access devices.
Possible Signs & Symptoms
Initial | Intermediate | Severe or Rapid |
Subtle signs may include:
Slight facial swelling Slight periorbital swelling Headache (worse when bending) Difficulty removing rings Dyspnea Red “mantle” that looks like a sunburn on the neck and shoulders These symptoms can dissipate after a few hours in the morning |
Worsening dyspnea
Cough Arm swelling Nasal stuffiness Chest pain / chest bruising Dysphagia (difficulty swallowing) Facial swelling-ruddy complexion Redness and edema of the conjunctivae |
Orthopnea
Stridor Respiratory distress Headache Visual disturbances Irritability Dizziness/ syncope Lethargy |
Palliation of Symptoms should be individualized to the requirements of each patient:
- Maintain a calm manner and contact physician immediately
- Health teaching for patient and families regarding condition
- Chemotherapy or radiation therapy are effective as initial treatment
- SVC stenting
- Thrombolytic therapy
- Drug Therapy may include: Steroids or Diuretics
Download Tip of the Month
PDF – Superior Vena Cava Syndrome
Sources:
- Ferrell, B & Coyle, N. (2006). Textbook of palliative nursing. 2nd Ed. Oxford University Press
- Pereira, J.L., Associates. (2013). The pallium palliative pocketbook: a peer-reviewed referenced resource.1st Ed. Edmonton, Canada.