In superior vena cava obstruction following are true.
A. Dyspnea
B. Palpitation
C. Oedema of the head and neck
D. Enlarged dilated veins on anterior chest wall
E. ↑ed JVP
Ans. A. Dyspnea (C) Oedema of head and
neck; (D) Enlarged dilated veins on anterior chest; (E) ↑ed JVP:
• Symptoms of superior vena cava syndrome (SVCS) : Swelling of
face and neck, dyspnea, and cough, hoarseness, tongue swelling, headaches,
nasal ongestion, epistaxis, hemoptysis, dysphagia, pain, dizziness, syncope and
lethargy, visual disturbances, stupor,
• Signs of SVCS : Non-pulsatile
distension of neck veins, oedema and cyanosis of head, neck, hands and arms,
dilated anastomatic veins on ant. chest wall. In more severe cases proptosis,
glossal and laryngeal edema, and obtundation.
• CXR : Superior mediastinal widening, most commonly on right side.
Note : Causes of SVCS:
— Malignancy (90%) like lung
cancer (particularly small cell and
squamous cell carcinoma accounts 85%
of all malignancies), lymphoma and metastatic tumours.
— Benign lesions: Chronic fibrotic mediastihum (e.g. T.B. histoplasmosis,
pyogenic infections, drugs), thrombophlebitis, aneurysm of aortic arch,
constrictive pericarditis.
• Rx of SVCS : Radiation therapy is primary Rx for SVCS caused by Ca Lung.
