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