Vena cava: The superior vena cava is the large vein which returns blood to the heart from the head, neck and both upper limbs. The inferior vena cava returns blood to the heart from the lower part of the body.
The return of blood via the vena cava can be compromised and cause disease. For example, in the superior vena cava syndrome, the symptoms that result from compression of the large vein that carries blood down to the heart.
The superior vena cava is located in the middle of the chest and is surrounded by rigid structures and lymph nodes. The structure bordering the superior vena cava include the trachea, aorta, thymus, right bronchus of the lung and pulmonary artery.
Compression of the superior vena cava by disease of any of the structures or lymph nodes surrounding the superior vena cava can cause the superior vena cava syndrome.
The superior vena cava syndrome is characterized by swelling of the face, neck and/or arms with visible widening (dilation) of the veins of the neck. Patients often have a persistent cough and shortness of breath. Others symptoms can be present including hoarseness, swelling around the eyes, fatigue, chest pain, headaches, and dizziness.
The causes of the superior vena cava syndrome include cancer (malignancies) and non-cancer (benign) conditions. The common forms of cancer that can cause the superior vena cava syndrome are lung cancer, lymphoma (cancer of the lymph nodes), and cancer that has spread (metastasis) to the chest, more commonly breast and testicular cancer. Non-cancer causes of the superior vena cava syndrome include infections (such as tuberculosis, fungus, and syphilis), benign tumors (such as teratomas, thymoma, dermoid cyst), aortic aneurysm, pericarditis, sarcoidosis, irradiation treatment to the chest, air in the chest (pneumothorax), and complication of central line catheters and congenital heart surgery.
Diagnosis of superior vena cava syndrome is supported by identifying a cause for the superior vena cava syndrome, typically requiring X- ray imaging or CAT or MRI scanning.
Treatment of superior vena cava syndrome is directed toward the exact underlying cause. Therefore, treatment might include radiation treatment, antibiotics, chemotherapy, clot-busting (thrombolytic) drugs, blood thinners (anticoagulation), and balloon angioplasty, and even surgery.
The outlook for patients with the superior vena cava syndrome clearly depends on the underlying cause of the syndrome.