BACK
TO
TOP
Browse A-Z
 
E-mail Form
Email Results

 
 
Print-Friendly
Bookmarks
bookmarks-menu

SVC obstruction

Superior vena cava obstruction; Superior vena cava syndrome

SVC obstruction is a narrowing or blockage of the superior vena cava (SVC), which is the second largest vein in the human body. The superior vena cava moves blood from the upper parts of the body to the heart.

Causes

SVC obstruction is a rare condition.

It is most often caused by cancer or a tumor in the mediastinum (the area of the chest under the breastbone and between the lungs).

Types of cancer that can lead to this condition include:

SVC obstruction can also be caused by noncancerous conditions that cause scarring near the SVC. These conditions include:

Other causes of SVC obstruction include:

  • Widening of the artery that leaves the heart (aortic aneurysm)
  • Blood clots in the SVC
  • Tightening of the thin lining of the heart (constrictive pericarditis)
  • Effects of radiation therapy for certain medical conditions
  • Enlargement of the thyroid gland (goiter)

Catheters placed in the large veins of the upper arm and neck may cause blood clots in the SVC.

Symptoms

Symptoms occur when something blocks the blood flowing back to the heart. Symptoms may begin suddenly or gradually, and may worsen when you bend over or lie down.

Early signs include:

  • Swelling around the eyes
  • Swelling of the face
  • Swelling of the whites of the eyes
  • Distended veins in the neck

The swelling may be worse or more prominent when lying down than when upright. It may be worse in the early morning hours and may go away by mid-morning.

The most common symptoms are shortness of breath (dyspnea) and swelling of the face, neck, trunk, and arms.

Other possible symptoms include:

  • Decreased alertness
  • Dizziness, fainting
  • Headache
  • Reddish face or cheeks
  • Reddish palms
  • Reddish mucous membranes (inside the nose, mouth, and other places)
  • Redness changing to blueness later
  • Sensation of head or ear fullness
  • Vision changes

Exams and Tests

Your health care provider will perform a physical exam, which may show enlarged veins of the face, neck, and upper chest. Blood pressure is often high in the arms and low in the legs.

If lung cancer is suspected, a bronchoscopy may be done. During this procedure, a camera is used to view inside the airways and lungs.

Blockage of the SVC may be visible on:

Treatment

The goal of treatment is to relieve the blockage.

Diuretics (water pills) or steroids (anti-inflammatory medicines) may be used to temporarily relieve swelling.

Other treatment options may include radiation therapy or chemotherapy to shrink the tumor, or surgery to remove the tumors. Surgery to bypass the obstruction is rarely performed. Placement of a stent (tube placed inside a blood vessel) to open up the SVC may be performed.

Outlook (Prognosis)

The outcome varies, depending on the cause and the amount of blockage.

SVC obstruction caused by a tumor is a sign that the tumor has spread, and it indicates a poorer long-term outlook.

Possible Complications

The throat could become blocked, which can block the airways.

Increased pressure may develop in the brain, leading to changed levels of consciousness, nausea, vomiting, or vision changes.

When to Contact a Medical Professional

Contact your provider if you develop symptoms of SVC obstruction. Complications are serious and can sometimes be fatal.

Prevention

Prompt treatment of other medical disorders may reduce the risk of developing SVC obstruction.

Open References

References

Gupta A, Kim DN, Kalva S, Reznik S, Johnson DH. Superior vena cava syndrome. In: Niederhuber JE, Armitage JO, Kastan MB, Doroshow JH, Tepper JE, eds. Abeloff's Clinical Oncology. 6th ed. Philadelphia, PA: Elsevier; 2020:chap 53.

Kinlay S, Bhatt DL. Treatment of noncoronary obstructive vascular disease. In: Libby P, Bonow RO, Mann DL, Tomaselli GF, Bhatt DL, Solomon SD, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 12th ed. Philadelphia, PA: Elsevier; 2022:chap 44.

  • Heart - section through the middle

    Heart - section through the middle - illustration

    The interior of the heart is composed of valves, chambers, and associated vessels.

    Heart - section through the middle

    illustration

  • Heart - section through the middle

    Heart - section through the middle - illustration

    The interior of the heart is composed of valves, chambers, and associated vessels.

    Heart - section through the middle

    illustration

Aspirus St. Luke’s, 915 East First Street, Duluth, MN 55805 218.249.5555 | 800.321.3790

Review Date: 2/13/2025

Reviewed By: Jacob Berman, MD, MPH, Clinical Assistant Professor of Medicine, Division of General Internal Medicine, University of Washington School of Medicine, Seattle, WA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. No warranty of any kind, either expressed or implied, is made as to the accuracy, reliability, timeliness, or correctness of any translations made by a third-party service of the information provided herein into any other language. © 1997- A.D.A.M., a business unit of Ebix, Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
© 1997- adam.com All rights reserved.