Superior Vena Cava Syndrome - Treatment

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How is superior vena cava syndrome treated?

Rarely does superior vena cava syndrome constitute a medical emergency. The ABCs of care are always a priority, insuring that the Airway is well maintained, Breathing is adequate and the Circulation (blood pressure and heart rate) is stable. The patient may feel more comfortable in an upright position. Furosemide (Lasix) is a diuretic that will decrease the volume of fluid within the bloodstream. With less pressure pushing against the obstructed superior vena cava, symptoms may be temporarily relieved.

Treatment needs to be directed to the underlying cause.

If the cause is a tumor or cancer, the treatment plan will need to be customized to the patient's condition and desires. Options include radiation with or without chemotherapy. Even with aggressive treatment with radiation, only 10 % of lung cancer patients with this syndrome survived to 30 months. Without any treatment, survival may be less than a month.

Steroids [for example, methylprednisolone (Medrol, Depo-Medrol) or prednisone (Deltasone, Liquid Pred)], may be considered to decrease the swelling of a tumor pressing on the superior vena cava and help relieve symptoms.

If the cause of superior vena cava syndrome is a blood clot, anticoagulation with (warfarin) Coumadin may be indicated. The use of thrombolytic drugs [for example, alteplase (Activase, TPA) or TNK] to break up the clot, or placement of a stent to keep the vein open may also be considered.

Special consideration

In children, superior vena cava syndrome is most often caused bynon-Hodgkin's lymphoma. The compression of the superior vena cava may be associated with compression of the trachea as well. The trachea (windpipe) in children is relatively narrow, flexible, and soft as compared with an adult. Airway obstruction may occur and manifest as:

  • difficulty breathing,
  • stridor (high-pitched, abnormal breathing sounds heard when breathing in), and
  • wheezing.
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See what others are saying

Comment from: Mzery, 45-54 Female (Patient) Published: February 23

I was diagnosed with superior vena cava syndrome after my portacath was removed. I had been treated for stage IV colon cancer, and finally got my port removed. It was difficult to get out as tissue formed over it. In a few short months, the entire vena cava was occluded as were both jugular veins and the main veins on both arms. My vascular surgeon attempted to relieve some of the pressure by trying to enlarge my collateral veins. It helped a little but still breathing and swelling are a huge issue. Diuretics helped a bit too as well as avoiding lying on my right side. I have no clue why but it seemed to help a bit. Also I sleep on a wedge and 5 pillows to stay upright more when I sleep.

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