Health Encyclopedia

SVC obstruction

Definition

SVC obstruction is a narrowing or blockage of the superior vena cava -- the second largest vein in the human body. The superior vena cava moves blood from the upper half of the body to the heart.

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 cancer in the mediastinum (the area of the chest under the breastbone and between the lungs). The types of cancer that can lead to this condition include lymphoma, cancer of the lung that spreads, breast cancer, testicular cancer, thyroid cancer, and thymic tumors.

Superior vena cava obstruction can also be caused by noncancerous conditions that cause chronic fibrosis (scarring). These conditions include lung infections (such as tuberculosis), histoplasmosis infection, and thrombophlebitis.

Other causes of superior vena cava obstruction include aortic aneurysm, constrictive pericarditis, and goiter.

Symptoms

Neck swelling, facial swelling, or arm swelling
Swelling around the eye socket (periorbital)
Sensation of head or ear "fullness"
Reddish face or cheeks
Reddish palms
Reddish mucous membranes (inside the nose, mouth, and so on)
Redness changing to blueness later
Headache
Dizziness
Vision changes
Fainting
Decreased alertness

Note: Symptoms may begin suddenly or gradually, and may worsen when bending over or lying down.

Signs and tests

An examination may show enlarged 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:

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

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 the obstruction is rarely performed. Placement of a stent to open up the SVC is available at some medical centers.

Expectations (prognosis)

The outcome varies depending on 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 other medical disorders may reduce the risk of developing SVC obstruction.

Review Date:5/3/2006
Reviewed By:William Matsui, MD, Assistant Professor of Oncology, Division of Hematologic Malignancies, The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD. Review provided by VeriMed Healthcare Network.

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