Oncological emergencies (except neutropenic sepsis!) Spinal cord compression


Superior Vena Cava Obstruction SYMPTOMS



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Superior Vena Cava Obstruction

  • SYMPTOMS:

  • Swelling of face, neck one or both arms.

    • (one arm suggests more distal)
  • Distended veins.

  • Shortness of breath.

  • Headache.

  • Lethargy.



Superior Vena Cava Obstruction



Superior Vena Cava Obstruction

  • SIGNS:

  • Early stage: puffy neck, neck veins don’t collapse.

  • Later:

    • Distended neck & chest wall
    • veins.
    • Swollen face, neck and arms.
  • In advanced cases:

    • Injected conjunctiva.
    • Sedation.


Superior Vena Cava Obstruction

  • Main aim is to distinguish whether obstruction is blockage from within:

    • Clot (DVT) – often fast onset.
    • Foreign body (e.g.line).
    • Tumour in vessel (e.g. renal cancer).
  • Or without:

    • Extrinsic compression from mass.


History

  • How long?

  • Speed of onset?

  • How advanced? If patient is becoming drowsy this is an emergency.

  • Any risk factors e.g. recent central line.

  • Any symptoms of cancer esp. lung cancer or lymphoma.


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