Uperior vena cava syndrome (svcs) was first described in l757 in a patient with a syphilitic

44

Hospital Physician January 1999

B h i m j i   :   S u p e r i o r   V e n a   C a v a   S y n d r o m e   :   p p .   4 2 – 4 6 ,   6 3

Table 3. Findings on Chest Radiography in Patients

with Superior Vena Cava Syndrome

Mediastinal widening

Pleural effusion(s)

Right hilar mass

Bilateral lung infiltrates

Cardiomegaly

Calcified paratracheal lymph nodes

Anterior mediastinal mass

Adapted with permission from Parish JM, Marschke RF Jr, Dines DE,

Lee RE: Etiologic considerations in superior vena cava syndrome.

Mayo Clin Proc 1981;56:407–413.

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Other diagnostic techniques.

Other diagnostic tech-

niques used in the evaluation of SVCS include bron-

choscopy, retinoscopy, cell cytology, and mediastin-

oscopy. In each case, the risks of intervention, such as

bleeding and perforation of the collateral circulation,

should be carefully weighed against the benefits for and

safety of the patient. Today, SVCS is seldom a medical

emergency and all efforts should be made to identify the

etiology. Although the specific etiology of SVCS can be

obtained by tissue diagnosis in a few cases, this proce-

dure may be difficult and even hazardous to the patient.

TREATMENT

Depending on the underlying condition, multiple

treatment options are available for superior vena cava

obstruction.

1, 9–19

The primary treatment options include

radiation, chemotherapy, thrombolytic therapy, antico-

agulation, stents and balloon angioplasty, and surgery.