Superior vena cava syndrome

Pathophysiology

Occurs in 3-8% with lung cancer and lymphoma

Symptoms due to venous hypertension in areas drained by SVC

Deaths occurs from cerebral edema, airway compromise, or cardiac compromise

Clinical features

Thoracic or neck vein distention - 65%

Shortness of breath - 50%

Tachypnea - 40%

Upper trunk or extremity edema - 40%

Cough/dysphagia/chest pain - 20%

Peri-orbital or facial edema - ?

Stroke's sign (tight shirt collar) - ?

Diagnosis

CXR shows mediastinal mass or paranchymal lung mass in 10%

CT is diagnostic

Management

Furosemide 40mg IV

Methylprednisolone 1-2 mg/kg IV

Mediastinal radiation

Source

Sotelo 10/09