• We are sorry, but NCBI web applications do not support your browser and may not function properly. More information

PubMed Health. A service of the National Library of Medicine, National Institutes of Health.

A.D.A.M. Medical Encyclopedia [Internet]. Atlanta (GA): A.D.A.M.; 2013.

A.D.A.M. Medical Encyclopedia.

SVC obstruction

Superior vena cava obstruction; Superior vena cava syndrome

Last reviewed: January 1, 2013.

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.

Causes, incidence, and risk factors

Superior vena cava (SVC) obstruction is a relatively rare condition.

Most often it is caused by cancer or a tumor 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:

Superior vena cava obstruction can also be caused by noncancerous conditions that cause scarring. These conditions include:

Other causes of superior vena cava obstruction include:

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

Symptoms

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

Early signs include:

  • Swelling around the eye
  • Swelling of the face
  • Swelling of the whites of the eyes

The swelling will most likely be worse in the early morning hours and 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:

  • Fainting
  • Headache
  • Reddish face or cheeks
  • Reddish palms
  • Reddish mucus membranes (inside the nose, mouth, and other places)
  • Redness changing to blueness later
  • Sensation of head or ear "fullness"
  • Vision changes

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 (a lighted tube placed through the mouth into the windpipe and lungs) may be performed if lung cancer is suspected.

Blockage of the SVC may be visible on:

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

Treatment

The goal of treatment is to relieve the blockage.

Diuretics (water pills) or steroids may be used to relieve swelling.

Other treatment options may include radiation or chemotherapy to shrink the tumor, or surgery to remove the tumors. 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 amount of blockage.

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

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.

Calling your health care provider

Call your health care 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.

References

  1. Rice TW, Rodriguez MR, Light RW. The superior vena cava syndrome: clinical characteristics and evolving etiology. Medicine (Baltimore). 2006;85;1:37-42. [PubMed: 16523051]
  2. Wilson LD, Detterbeck FC, Yahalom J. Superior vena cava syndrome with malignant causes. N Engl J Med. 2007;356:1862-1869. [PubMed: 17476012]
  3. Ugras-Rey S, Watson M. Selected oncologic emergencies. In: Marx JA, Hockberger RS, Walls RM, et al, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 7th ed. Philadelphia, Pa: Mosby Elsevier;2009:chap 121.

Review Date: 1/1/2013.

Reviewed by: Jacob L. Heller, MD, MHA, Emergency Medicine, Virginia Mason Medical Center, Seattle, Washington. Also reviewed by A.D.A.M. Health Solutions, Ebix, Inc., Editorial Team: David Zieve, MD, MHA, David R. Eltz, Stephanie Slon, and Nissi Wang.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org). URAC's accreditation program is an independent audit to verify that A.D.A.M. follows rigorous standards of quality and accountability. A.D.A.M. is among the first to achieve this important distinction for online health information and services. Learn more about A.D.A.M.'s editorial policy, editorial process and privacy policy. A.D.A.M. is also a founding member of Hi-Ethics and subscribes to the principles of the Health on the Net Foundation (www.hon.ch).

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. Call 911 for all medical emergencies. Links to other sites are provided for information only — they do not constitute endorsementscof those other sites. © 1997–2011 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.

Copyright © 2013, A.D.A.M., Inc.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org). URAC's accreditation program is an independent audit to verify that A.D.A.M. follows rigorous standards of quality and accountability. A.D.A.M. is among the first to achieve this important distinction for online health information and services. Learn more about A.D.A.M.'s editorial policy, editorial process and privacy policy. A.D.A.M. is also a founding member of Hi-Ethics and subscribes to the principles of the Health on the Net Foundation (www.hon.ch).

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. Call 911 for all medical emergencies. Links to other sites are provided for information only — they do not constitute endorsementscof those other sites. © 1997–2011 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.

Copyright © 2013, A.D.A.M., Inc.

What works?

See all (3) ...

Figures

  • Heart, section through the middle.

PubMed Health Blog...

read all...

MedlinePlus.gov links to free, reliable, up-to-date health information from the National Institutes of Health (NIH) and other trusted health organizations.

Recent Activity

Your browsing activity is empty.

Activity recording is turned off.

Turn recording back on

See more...