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Medical Author:

Benjamin Wedro, MD, FACEP, FAAEM

Benjamin Wedro, MD, FACEP, FAAEM

Dr. Ben Wedro practices emergency medicine at Gundersen Clinic, a regional trauma center in La Crosse, Wisconsin. His background includes undergraduate and medical studies at the University of Alberta, a Family Practice internship at Queen's University in Kingston, Ontario and residency training in Emergency Medicine at the University of Oklahoma Health Sciences Center.

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Medical Editor:

Melissa Conrad Stöppler, MD

Melissa Conrad Stöppler, MD

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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In this Article

• Introduction
• What causes superior vena cava syndrome?
• What are the symptoms of superior vena cava syndrome?
• How is superior vena cava syndrome diagnosed?
• How is superior vena cava syndrome treated?
• What is the prognosis for superior vena cava syndrome?
• Superior Vena Cava Syndrome At A Glance
• Find a local Cardiologist in your town
• Superior Vena Cava Syndrome Index

Initially, there are few symptoms, however, over time, symptoms of superior vena cava gradually develop. As the compression becomes more severe, the patient may develop shortness of breath and swelling of the arms and face. The symptoms occur because blood cannot return to the heart.

Without adequate blood return, it is hard for the heart to pump newly oxygenated blood to meet the metabolic needs of the body. If blood cannot return to the heart, it starts to back up and causes swelling of the areas where the backup occurs.

Less common symptoms include:

• dilation of veins on the skin surface as the body tries to establish new circulatory pathways to bypass the blockage, and a blue tinge to the skin (because the backed up blood doesn't have enough oxygen content)
  
  
• cough,
  
  
• shortness of breath,
  
  
• chest pain, and
  
  
• hoarseness.

• A plain chest x-ray may show abnormal enlargement of the mediastinum or may reveal a tumor in the lung.
  
  
• Ultrasound may be used to look for blood clots in the arm leading into the chest.
  
  
• Computerized tomography (CT) scanning of the chest is most often used to diagnose superior vena cava syndrome. While it will show the blockage and may show a tumor, it will not necessarily diagnose the type of tumor.
  
  
• If a tumor is the cause of the obstruction, often a surgical procedure will be required to obtain a biopsy (a small piece of tissue), to help make the specific diagnosis as to the type of tumor.