Superior vena cava syndrome.

The symptoms that result from compression of the superior vena cava are known as superior vena cava syndrome. The syndrome was originally described as secondary to infection such as tuberculosis or syphilitic aortic aneurysm. Currently, the origin is generally cancer or thrombotic events. Adenocarcinoma of the lung is the most common cause. Thrombotic causes are increasing because of the rise in use of pacemakers and central venous catheters for access or treatment purposes. Symptoms may include a feeling of fullness in the head, dyspnea, and cough. Clinical findings may include facial and neck swelling; dilated venous channels over the trunk, upper extremities, and neck; facial flushing; cyanosis; respiratory stridor and distress; and neurologic signs. Primary symptoms are in the neck and head. Treatment of superior vena cava syndrome will depend on the cause of the compression. If thrombosis is found, thrombolysis and anticoagulation may be indicated. With carcinoma or infection, specific drugs or radiation may be used. In cases of compression, dilation and stenting of the superior vena cava may be performed. In some cases a bypass of the superior vena cava may be indicated.