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

Alternative Names

Superior vena cava obstruction; Superior vena cava syndrome

Causes, incidence, and risk factors

Superior vena cava (SVC) obstruction is a relatively rare condition. Most often it is caused by variety of cancers that can be found in the mediastinum (the area of the chest under the breastbone and between the lungs). These can include lymphomas, cancer of the lung with extension into the mediastinum, breast cancer, testicular cancer, thyroid cancer, and thymic tumors. Superior vena cava syndrome can also be caused by non cancerous conditions that cause chronic fibrosis (scarring). These can 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 goiters.

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

MRI of chest

or

CT scan of the chest

coronary angiography

Doppler ultrasound

radionuclide ventriculography

This disease may also alter the results of the following tests:

liver scan

abdominal MRI

Treatment

The goal of treatment is relief of the obstruction.

Diuretics may be used to relieve swelling . The cause must be identified and treated. This may include radiation, chemotherapy , surgical removal of tumors, or other treatment. Surgery to bypass of the obstruction is rarely performed.

Expectations (prognosis)

The outcome varies depending of the cause and the extent of obstruction.

Complications

The throat could swell and block the airways.

Calling your health care provider

Call your health care provider if a lung tumor is present and symptoms indicate SVC obstruction may be present. Complications are serious and can sometimes be fatal.

Prevention

Prompt treatment of causative disorders may reduce the risk of development of SVC obstruction.