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.