Superior Vena Cava Syndrome

KEYPOINTS

  • A syndrome of dyspnea, headache, swelling of the face, neck and upper limbs should alert to this possible diagnosis. Occurs as a result of compression or obstruction of the superior vena cava
  • Can sometimes be life threatening but usually occurs with a gradual increase in signs and symptoms

ASSESSMENT

(see Foreword)

  • Chest X Ray or CT Scan will aid diagnosis

MANAGEMENT

  • Dexamethasone should be used in the short term
  • Radiotherapy may help with tumour causing external compression
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Consider if patient is well enough to benefit

PITFALLS/CONCERNS

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  • Tends to occur late in the disease trajectory of children

PALLIATIVE TIPS

  • May also be caused by thrombus around a subclavian arterial catheter

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