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Dilatation of the superior vena cava. Inferior vena cava syndrome: symptoms and treatment

During pregnancy, a woman's body experiences significant stress. The volume of circulating blood increases, conditions for venous stagnation appear.

The growing uterus squeezes blood vessels and surrounding organs, causing disruption of blood supply. One result of these changes is inferior vena cava syndrome. Its hidden manifestations are present in more than half of women, and clinically it manifests itself in every tenth pregnant woman. Severe cases of this disease occur in one in a hundred pregnant women.

Synonyms for this condition:

  • hypotensive syndrome on the back;
  • aortocaval compression syndrome;
  • postural hypotensive syndrome;
  • hypotensive syndrome of pregnant women in the supine position.

Why does this condition occur?


Inferior vena cava compression syndrome usually occurs when the pregnant woman is lying on her back.

The inferior vena cava is a large diameter vessel through which from the legs and internal organs venous blood is drained. It is located along the spine. Its walls are soft, the pressure in venous system low, so the vein is easily compressed by the enlarged uterus.

Signs of such compression begin to occur periodically in the third trimester of pregnancy if the woman is in a supine position.

When this large vein is compressed, the outflow of blood through it to the heart is hampered, that is, venous return is reduced. As a result, the volume of blood passing through the lungs through the pulmonary circulation decreases. Blood oxygen saturation decreases, hypoxemia occurs.

Decreases cardiac output- the amount of blood ejected by the heart into the aorta. As a result of a small amount of blood and a reduced oxygen content in it, a lack of this gas occurs in all tissues - hypoxia. All organs of the woman and fetus suffer.

Suddenly, blood pressure drops quickly, in some cases to 50/0 mmHg. Art.

On the other hand, a compressed inferior vena cava cannot pass the entire volume of venous blood from the legs and lower torso to the right atrium. Therefore, venous congestion develops in the veins of the lower extremities.

In the development of inferior vena cava syndrome, an increase in intra-abdominal pressure due to the growing uterus, elevation of the diaphragm and compression of all great vessels are important abdominal cavity and retroperitoneal space. Many pregnant women develop a network of collaterals - bypasses venous outflow, as a result of which the syndrome in question does not occur in them.


How does the condition manifest?

The inferior vena cava is compressed by the enlarged uterus when the woman is lying on her back. At long gestation periods or with polyhydramnios, this can also occur in vertical position bodies.

The first symptoms appear at about 25 weeks. It becomes difficult for a woman to lie on her back, and she may experience dizziness, shortness of breath, and weakness. Blood pressure decreases. In some cases, even collapse with fainting occurs.

In severe cases, a woman quickly turns pale 2–3 minutes after turning on her back, complains of dizziness and darkening in the eyes, nausea and cold sweat. More rare signs– ringing in the ears, heaviness behind the sternum, feeling of strong fetal movement.

Sudden onset of pallor and hypotonia closely resembles internal bleeding, so the doctor may mistakenly suspect placental abruption, uterine rupture, etc. in such a pregnant woman.

The appearance of a vascular pattern is also associated with the described syndrome. One of frequent manifestations this state is .

Described pathological condition leads to fetal hypoxia and disturbance of its heartbeat. The development of organs and systems of the unborn child suffers. If it occurs during childbirth, it can cause fetal asphyxia. The connection of this disease with premature detachment normally located placenta.

What to do in this condition


The optimal position for a pregnant woman during sleep is lying on her left side.

What not to do in the third trimester of pregnancy:

  • A pregnant woman over 25 weeks should not sleep on her back;
  • prohibited from practicing physical exercise performed lying on your back, including with tension in the abdominal muscles.
  • It is recommended to rest lying on your left side or in a semi-sitting position;
  • It is useful to use special pillows for pregnant women, which are placed under the back or between the legs when lying on your side. Changing body position helps prevent compression of abdominal vessels by the uterus;
  • To normalize venous outflow and improve hemodynamics, rational physical activity, especially walking, is recommended. While walking, the muscles of the legs actively contract, which helps move venous blood upward;
  • Exercises in water are useful. Water has a compression effect, squeezing blood out of the veins of the lower extremities;
  • During childbirth, the preferred position is lying on the left side or with the head end of the bed raised high.

is a symptom complex that develops as a result of circulatory disorders in the superior vena cava system and difficulty in the outflow of venous blood from the upper parts of the body. Classic signs of superior vena cava syndrome are: cyanosis; puffiness of the head, neck, upper limbs, upper half chest; expansion of saphenous veins; shortness of breath, hoarseness, cough, etc. General cerebral, ocular, and hemorrhagic manifestations often develop. Diagnostic algorithm may include radiography of OGK, venocavagraphy, CT and MRI of the chest, ultrasound, mediastinoscopy, thoracoscopy with biopsy. In case of the syndrome, endovascular balloon angioplasty and stenting, thrombectomy, resection of the SVC, bypass surgery, and palliative removal of the tumor to decompress the mediastinum can be performed.

General information

Superior vena cava syndrome (SVVC), or cava syndrome, is understood as a secondary pathological condition that complicates many diseases associated with damage to the mediastinal organs. The basis of cava syndrome is extravasal compression or thrombosis of the superior vena cava, which disrupts the outflow of venous blood from the head, shoulder girdle and the upper half of the body, which can lead to life-threatening complications. Superior vena cava syndrome develops 3-4 times more often in male patients aged 30-60 years. IN clinical practice specialists in the field have to deal with superior vena cava syndrome thoracic surgery and pulmonology, oncology, cardiac surgery, phlebology.

The superior vena cava (SVC) is located in the middle mediastinum. It is a thin-walled vessel surrounded by dense structures - chest wall, aorta, trachea, bronchi, chain of lymph nodes. Features of the structure and topography of the SVC, as well as physiologically low venous pressure, cause easy occurrence of obstruction main vessel. The SVC drains blood from the head, neck, upper shoulder girdle and upper chest. The superior vena cava has a system of anastomoses that perform a compensatory function when the patency of the SVC is impaired. However, venous collaterals cannot completely replace the SVC. With superior vena cava syndrome, the pressure in its pool can reach 200-500 mm of water. Art.

Causes of SVPV

The following pathological processes can contribute to the development of superior vena cava syndrome: extravasal compression of the SVC, tumor invasion of the SVC wall, or thrombosis. In 80-90% of cases, the direct causes of cava syndrome are lung cancer, predominantly right-sided localization (small cell, squamous cell, adenocarcinoma); lymphogranulomatosis, lymphomas; metastases of breast cancer, prostate cancer and testicular cancer in the mediastinum; sarcoma, etc.

In other cases, compression of the SVC can be caused by benign tumors of the mediastinum (cysts, thymomas), fibrous mediastinitis, aortic aneurysm, constrictive pericarditis, infectious lesions: (syphilis, tuberculosis, histoplasmosis), substernal goiter. Superior vena cava syndrome may be caused by SVC thrombosis developing against the background of long-term catheterization of a vein by the central venous catheter or the presence of pacemaker electrodes in it.

Symptoms of SVPV

Clinical manifestations of superior vena cava syndrome are caused by increased venous pressure in vessels from which blood normally flows through the SVC or innominate veins. The severity of manifestations is influenced by the rate of development of the superior vena cava syndrome, the level and degree of circulatory impairment, and the adequacy of collateral venous outflow. Depending on this clinical course superior vena cava syndrome can be slowly progressive (with compression and invasion of the SVC) or acute (with SVC thrombosis).

The classic triad that characterizes superior vena cava syndrome includes edema, cyanosis, and dilatation of the superficial veins of the face, neck, upper limbs and the upper half of the body. Patients may be bothered by shortness of breath at rest, attacks of suffocation, hoarseness, dysphagia, cough, chest pain. Symptoms mentioned worsen in a lying position, so patients are forced to take a semi-sitting position in bed. In a third of cases, stridor is noted, caused by laryngeal edema and threatening obstruction. respiratory tract.

Complications

Often, with superior vena cava syndrome, nasal, pulmonary, and esophageal bleeding develop, caused by venous hypertension and rupture of thinned vessel walls.

Violation of the venous outflow from the cranial cavity leads to the development of cerebral symptoms:

  • headache
  • noise in the head
  • drowsiness
  • confusion and loss of consciousness.

Due to dysfunction of the oculomotor and auditory nerves may develop:

  • diplopia
  • bilateral exophthalmos
  • lacrimation
  • eye fatigue
  • decreased visual acuity
  • auditory hallucinations

Diagnostics

Physical examination of a patient with superior vena cava syndrome reveals swelling of the veins of the neck, an expanded network of subcutaneous venous vessels in the chest, plethora or cyanosis of the face, and swelling of the upper half of the torso. If superior vena cava syndrome is suspected, all patients are advised to x-ray examination- chest radiography in two projections, tomography (computer, spiral, magnetic resonance). In some cases, to determine the location and severity of venous obstruction, phlebography (venocavagraphy) is used.

CT scan of the chest. A sharp narrowing of the lumen of the superior vena cava due to the growth of a mediastinal tumor into it with severe difficulty in the outflow of venous blood from the head and upper extremities

With a purpose differential diagnosis For SVC thrombosis and external obstruction, ultrasound examination of the carotid and supraclavicular veins is indicated. Examination of the fundus by an ophthalmologist reveals tortuosity and dilatation of the retinal veins, edema of the peripapillary region, and congestive disc optic nerve. When measuring intraocular pressure, a significant increase may be noted.

To determine the causes of superior vena cava syndrome and verify the morphological diagnosis, bronchoscopy with biopsy and sputum sampling may be required; sputum analysis for atypical cells, cytological examination of bronchial washings, biopsy lymph node(prescale biopsy), sternal puncture with myelogram examination. If necessary, diagnostic thoracoscopy, mediastinoscopy, mediastinotomy, or parasternal thoracotomy may be performed to explore and biopsy the mediastinum.

Differential diagnosis of cava syndrome is carried out with congestive heart failure: with superior vena cava syndrome there is no peripheral edema, hydrothorax, or ascites.

Treatment of SVPV

Symptomatic treatment of superior vena cava syndrome is aimed at increasing the functional reserves of the body. It includes the appointment of a low-salt diet, oxygen inhalation, diuretics, and glucocorticoids. After establishing the cause that caused the development of superior vena cava syndrome, pathogenetic treatment is carried out.

Thus, with superior vena cava syndrome caused by lung cancer, lymphoma, lymphogranulomatosis, metastases of tumors in other locations, polychemotherapy and radiation therapy are carried out. If the development of superior vena cava syndrome is caused by thrombosis of the SVC, thrombolytic therapy is prescribed, thrombectomy is performed, and in some cases, resection of a segment of the superior vena cava with replacement of the resected area with a venous homograft.

With extravasal compression of the SVC, radical interventions may include extended removal of a mediastinal tumor, removal of a mediastinal lymphoma, thoracoscopic removal of a benign mediastinal tumor, removal of a mediastinal cyst, etc. If it is impossible to perform radical surgery resort to various palliatives surgical interventions, aimed at improving venous outflow: removal of the mediastinal tumor for the purpose of decompression, bypass surgery, percutaneous endovascular balloon angioplasty and stenting of the superior vena cava.

Forecast

Long-term results of treatment for superior vena cava syndrome depend, first of all, on the underlying disease and its capabilities. radical treatment. Elimination of the causes leads to relief of the manifestations of cava syndrome. The acute course of superior vena cava syndrome can cause rapid death of the patient. With superior vena cava syndrome caused by advanced cancer, the prognosis is unfavorable.

A sharp difficulty or complete cessation of blood flow through the superior vena cava is called “superior vena cava syndrome”, or “cava syndrome”.

The first description of this disease belongs to Gunther (1754). Since that time, it has been described in sufficient detail from the pathoanatomical and clinical side, although all this was only of academic significance, since its treatment was reduced only to the prescription of symptomatic remedies. Literature data have shown that venous obstruction is much more common than previously thought. This disease is not always recognized correctly due to insufficient familiarity with it among practitioners.

For ease of understanding, the causes of the development of this disease can be grouped as follows:

  • compression of a venous vessel (with lumen thrombosis) by malignant or benign tumors mediastinal organs (bronchus cancer, tumor thymus gland, intrathoracic goiter);
  • compression of a venous vessel (with thrombosis) by tumor-like formations of the mediastinum (aortic aneurysm, enlarged lymph nodes);
  • development of venous vessel obstruction due to inflammatory changes: spread of thrombophlebitis of peripheral veins - innominate, subclavian, surrounding tissues (fibrous mediastinitis, lymphadenitis).

In the first two groups, compression of the venous vessels from the outside or obstruction of the lumen by a tumor comes to the fore; the third group consists of true thrombosis, which in some cases develops as a result of transition inflammatory process with thrombophlebitis of the subclavian or innominate veins with a clear clinical picture of this suffering, in other cases - on the basis of lately increased.

When complete obstruction of a venous vessel has developed, it is often difficult to decide whether the primary process is intra- or extravascular. In both cases, this leads to cessation of blood flow through the vein, which causes the development of a clinically obvious venous collateral circulation.

There are four main systems collateral blood flow superior vena cava.

The system of vertebral and saphenous veins forms collateral circulation when there is blockage of any location. The other two pathways - the azygos vein system (azygos), internal mammary veins (mammariae internae) - develop depending on the location of the blockage.

If there is a blockage above the confluence of v. azygos, the latter takes on the task of roundabout circulation, but the blood (via collaterals) flows in the normal direction and, reaching the free lower part of the vein, flows into it and further into the right atrium. During outflow large quantity blood along collaterals v. azygos can expand to significant sizes.

Blockage at the junction of the azygos vein (in fact, blockage of both of these veins) does not cause expansion of the lumen of the azygos vein, but leads to the formation of reverse blood flow, which reaches the inferior vena cava through the azygos-lumbar anastomoses (arches).

Blockage below the confluence of the azygos vein makes the latter very in an important way outflow of blood, due to which it expands sharply, and the current blood is flowing in the opposite direction through anastomoses into the inferior vena cava. A blood outflow system is also created during thrombosis of the junction of the superior vena cava into the atrium.

Domestic thoracic veins also always participate in education collateral pathways outflow in superior vena cava syndrome, but the degree of their participation varies. When the innominate veins are blocked and disabled, they expand sharply. Blockage below the confluence of the azygos vein allows the latter to be used as a collateral route.

Thus, the main ones are the last two pathways of collateral circulation, developing depending on the location of the blockage in relation to the mouth of the azygos vein. Due to the development of collaterals, blockage of a venous vessel often occurs without a clearly defined picture.

Symptoms of superior vena cava syndrome

Symptoms in severe cases are quite striking and are characterized by a triad of symptoms: cyanosis (cyanosis) and dilatation of the superficial veins of the head, neck and shoulder girdle. Degree of expression clinical symptoms can be varied, depending on the location and extent of the vein blockage, the degree of development of collaterals, which are always very abundant here. Subsequently, as other mediastinal organs become involved, shortness of breath, palpitations, neurological symptoms, especially increasing with physical activity.

Recognition of superior vena cava syndrome is not difficult and is based on the presence of the above triad of symptoms. However, it should be remembered that there is a direct relationship between the degree of vascular blockage and clinical manifestations no, the severity of the latter depends on the location and extent of the blockage.

The nature of the pathological process as the cause of blood flow disturbance is established complex method examinations. Thus, to establish damage to the venous trunks, venography is necessary, for mediastinal tumors - tomography and pneumomediastinography, for suspected bronchial cancer - bronchoscopy and bronchography.

With the slow progression of superior vena cava syndrome, it is often not possible to observe all characteristic features. In particular, swelling may be mild. However, the patient’s complaints of dizziness, shortness of breath, and attacks of suffocation give reason to suspect a blockage. Patients with this lesion cannot be in a horizontal position and even sleep while sitting; constant feeling tension in the head increases sharply when bending forward. Dilation of venous collaterals sometimes leads to nosebleeds or throat bleeds.

Diagnosis of superior vena cava syndrome

Measurement of venous pressure may be helpful in diagnosis. U healthy person in the veins of the elbow venous pressure in supine position ranges from 50 to 150 mm water column. When you inhale, the pressure increases slightly, and when you exhale, it increases. An increase in venous pressure during inspiration indicates thrombosis of the superior vena cava. High venous pressure in the upper extremities with normal levels in the lower extremities should suggest a blockage.

Exercise testing allows one to differentiate thrombosis of the superior vena cava from increased venous pressure due to heart disease; in case of circulatory disorders due to heart disease, venous pressure does not change significantly during physical activity.

The most valuable diagnostic method, allowing to localize the blockage and identify collaterals, is venography. The method of choice should be the introduction of contrast agents into the vein of the elbow on one or both sides.

The article was prepared and edited by: surgeon

The superior vena cava is a vein that carries waste blood from the upper body to the heart for new oxygenation.

Superior vena cava syndrome is often a secondary problem that is caused by cancerous tumor or a blood clot obstructing blood flow through a given vein.

This syndrome was previously considered a medical emergency. However, now doctors do not think so. However, people who have symptoms of this syndrome should be examined by a doctor quickly.

What is superior vena cava syndrome?

The superior vena cava is the larger of two veins that carry oxygen-depleted blood back to the heart.

The superior vena cava carries waste blood from the head and upper body to the right atrium (superior chamber). This vein is located in the middle of the chest and is surrounded by lymph nodes.

Superior vena cava syndrome is the name given to symptoms, which occurs when blood flow through the superior vena cava is obstructed or blocked.

Symptoms include breathing problems, swelling of the upper body and dizziness.

Reasons

Superior vena cava syndrome is a complication of another medical problem, such as a swollen lymph node that obstructs blood flow through the vein, or a tumor.

Common causes of superior vena cava syndrome:

  • non-Hodgkin's lymphomas;
  • lung cancer.

Less common causes of superior vena cava syndrome:

  • metastatic breast cancer;
  • colon cancer;
  • esophageal cancer;
  • Cancer thyroid gland;
  • Hodgkin's lymphoma;
  • blood clots from an intravenous catheter or pacemaker;
  • serious respiratory tract infections such as tuberculosis;
  • some diseases immune system, such as Adamantiadis-Behçet disease.

Symptoms

If the obstruction in blood flow that causes the syndrome does not progress to a complete blockage, the person may not experience symptoms.

More often than not, a person with a partial blockage has moderate symptoms, to which he may not pay attention.

If the blockage is complete or gets worse quickly, the person will likely experience severe symptoms.

Symptoms may include a combination of the following:

  • cough;
  • difficulty breathing or swallowing;
  • hoarseness;
  • chest pain;
  • coughing up blood;
  • swollen veins in the neck or chest;
  • swelling of the hands;
  • facial swelling;
  • stridor or wheezing;
  • nausea;
  • dizziness;
  • redness on the chest or neck.

Superior vena cava syndrome in children

Although superior vena cava syndrome occurs rarely in children, it is a medical emergency. Windpipe a child's is smaller and less rigid than an adult's, making them more prone to swelling quickly and causing breathing problems. Symptoms are often similar to those seen in adults and are often due to lymphoma (cancer of the lymphatic system).

Symptoms during pregnancy

Pregnant women in the late second and third trimesters may have a condition similar to this syndrome. Symptoms occur when the inferior vena cava (the smaller of the two veins that carries oxygen-depleted blood back to the heart) becomes pinched due to pressure from the fetus and an enlarged uterus.

A pregnant woman may experience dizziness and low blood pressure when lying flat on her back. If you lie on your left side, the symptoms often disappear.

Diagnostics

If a doctor suspects a person has superior vena cava syndrome, they will first do a physical examination. Examination may reveal enlarged veins in the chest and neck.

If the examination results suggest the presence of such a syndrome, the doctor will most likely prescribe additional examinations:

  • chest x-ray to detect tumors in the lungs or breast enlargements;
  • CT scan to detect blockage;
  • venography - x-ray of veins after injection of a special dye that makes the veins visible;
  • ultrasound for searching blood clots in the upper limbs.

If a tumor is found to be causing the blockage, the doctor may order a biopsy to determine what type of tumor is causing the problem. For proper treatment, it is important to know whether the tumor is cancerous or benign.

Treatment

In most cases where superior vena cava syndrome is detected, treatment is aimed at reducing the symptoms and the tumor causing the blockage. If the case is mild, waiting under observation may be the only recommended treatment.

Many people with this syndrome see significant improvements in their symptoms by holding their head up high and using supplemental oxygen. Some doctors also try to reduce swelling by prescribing steroids.

Most treatments for the syndrome focus on the reason why it occurs. Since most cases are due to cancer, suitable treatment is key. Treatment will vary depending on the type of cancer and may include a combination of chemotherapy and radiation.

In cases where the syndrome is caused by a blood clot, blood thinners may be prescribed. A stent may be used to unblock the vein. IN in rare cases Bypass surgery may be required.

Forecast

Usually, the symptoms of superior vena cava syndrome have a clear improvement after a month of treatment. However, since most cases are caused by cancer, general forecast greatly depends on its type and stage.

Cava syndrome, or superior vena cava syndrome, is a complex specific signs with impaired blood circulation in the upper body. Characteristic symptoms include swelling of the neck, cyanosis of the skin and severe dilatation of the veins. If these symptoms appear, immediate medical attention is needed.

Kava syndrome is often accompanying symptom oncological processes affecting the circulatory and pulmonary systems. Pathology can occur in people different ages and floors. The syndrome is diagnosed in several percent of cases in pregnant women and children.

Description of the disease and its complications

The superior vena cava is located in the internal space of the middle section chest cavity. It is surrounded by other tissues: the sternum wall, trachea, bronchi, aorta, lymph nodes. Its function: ensuring the outflow of blood from the lungs, head, and upper torso.

Superior vena cava syndrome is a complex of specific symptoms of impaired blood circulation in the upper body

Superior vena cava syndrome is a disruption of normal blood circulation in the upper torso and head. This vessel can be compressed and change its structure during many pathological processes. As a result, the flow of blood from the arms, hands, face, head and neck is disrupted. The blood stagnates.

With superior vena cava syndrome, the danger is high blood pressure. In severe cases, this is 200-250 units in systole, which is life-threatening. Men aged 30 to 60 years are most susceptible to the syndrome.

If left untreated, the patient may experience the following complications:

  • Various bleedings, which are diagnosed mainly in the upper body. The patient will be bothered by bloody discharge from the nose, eyes, and a cough that may be streaked with blood.
  • Stagnation of blood can cause sagittal sinus thrombosis.
  • Impaired blood flow from the head causes swelling of the brain, severe headaches, and increased intracranial pressure.
  • The most dangerous consequence syndrome is hemorrhagic stroke. The effusion of blood into the cranial cavity is very dangerous; in half of the cases, patients experience paralysis and muscle paresis. Death often occurs.

The most dangerous consequence of the syndrome is hemorrhagic stroke

Clinical picture

Thrombosis causes dysfunction of the oculomotor or auditory nerves. It can develop quickly or gradually. In the second case, collaterals have time to form, that is, alternative pathways for blood outflow. On initial stage the disease is almost asymptomatic. If the process of blood clot formation develops quickly, the pathology will be severe. The syndrome develops within 10-20 days.

The forced position during rest and sleep is a semi-recumbent position. Sleeping at night becomes impossible without the use of sleeping pills.

Causes of the syndrome

Common causes of the syndrome are poor lifestyle and bad habits which result in poor circulation. Less commonly, the development of cava syndrome is provoked by malignant neoplasms:

  • blood cancer;
  • brain sarcoma;
  • oncological processes in the pelvic organs.

Blood cancer can cause this syndrome

The development of the syndrome is often associated with the formation of multiple metastases that penetrate the vena cava. Sometimes the syndrome can occur due to cancer of the lungs, pleura, thyroid gland or as a consequence of post-radiation fibrosis.

Sometimes pathology develops as a result of prolonged catheterization. This provokes the appearance of sclerosis or thrombosis. The occurrence of superior vena cava syndrome in children is often associated with long-term catheterization of the vena cava in oncology.

Superior vena cava syndrome sometimes provokes an increased volume of circulating blood. In pregnant women, it becomes the result of venous stagnation. Uterus on later presses on the diaphragm and the greater vena cava. A decrease in oxygen levels has a bad effect on a woman’s organs and fetal development slows down. In the last trimester it is provoked by prolonged lying on the back.

Symptoms

As stated earlier, few patients pay attention to symptoms, much less early stages the disease has no obvious clinical signs. Sometimes there is an increase blood pressure, which is often attributed to nervous tension.

For superior vena cava syndrome clinical picture additional characteristic features:

  • the neck becomes swollen;
  • bloating of veins is observed on the face, neck, forehead;

Swelling in the neck indicates the presence of pathology

  • the face becomes swollen, small capillaries under the skin burst;
  • the skin of the face, hands, and neck acquires a characteristic blue tint, due to a violation of the outflow of venous blood.

Any of the symptoms noticed requires urgent appeal see a doctor. Call emergency assistance if symptoms develop very quickly.

With the slow development of superior vena cava syndrome, a person is concerned about:

  • Breathing disorders. This may be shortness of breath, even at rest, a feeling of lack of air, inability to breathe.
  • Swallowing disorder. The patient cannot eat or drink.
  • A cough appears, which gets worse over time. The cough itself is dry, but may be streaked with blood.
  • Forgetfulness, dizziness, headaches, cramps of the lower and upper extremities.

The severity of symptoms depends on the speed of development and the number of collaterals formed.

Diagnostics

First, the patient must contact a therapist, cardiologist and neurologist for a correct diagnosis. The syndrome is diagnosed through questioning, medical history, and instrumental methods research.

One of the types of diagnostics is magnetic resonance therapy

The patient may be prescribed:

  • X-ray of the chest in 2 projections;
  • vascular angiography;
  • computed tomography;
  • magnetic resonance therapy.

The last two methods are the most informative. Often a consultation with an ophthalmologist, ENT specialist, and, if necessary, an oncologist is required.

Bronchoscopy and biopsy will help in diagnosing superior vena cava syndrome in more detail. lung tissue and lymph nodes, thoracoscopy (examination pleural cavity). This examination reveals the degree of obstruction of the vena cava.

Treatment

In case of secondary superior vena cava syndrome, treatment is symptomatic. It is used together with the main therapy. The purpose of auxiliary treatment is to maintain the body's internal reserves. Conservative therapy includes:

  • oxygen inhalations;
  • diuretics;
  • cortecosteroids.

Diuretics in the treatment of this syndrome

At severe course Superior vena cava syndrome will require surgery. The patient may be prescribed:

  • thrombectomy;
  • resection of the damaged section of the vena cava (a homoimplant is installed in its place);
  • shunting (bypass of blood outflow);
  • removal of mediastinal cysts;
  • stenting of the greater vena cava.

Long-term catheterization will require balloon dilatation of the damaged area.

Prognosis for superior vena cava symptom

At secondary syndrome superior vena cava good forecasts impossible without successful primary therapy. Only removing the root cause will help stop pathological process. The prognosis is unfavorable if there is an oncological factor provoking the syndrome, or if it acute course. During pregnancy, the disease provokes fetal hypoxia.

Conclusions

Superior vena cava syndrome is a change caused by long-term compression of the vena cava or its obstruction. Its causes may be different, but successful treatment is possible only when the root cause is completely cured.

Acute development of the syndrome leads to the death of a person. At the first symptoms, the patient urgently needs medical attention.