Superior Vena Cava Syndrome (cont.)
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 by
non-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.
Next: What is the prognosis for superior vena cava syndrome? »
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