Superior Vena Cava Obstruction (SVCO)

Question 1

What are the clinical features of SVCO?

Answer 1

Face & arm swelling (odema)

Progressive SOB

Headaches

Plethora (red face)

Weight loss

Productive cough

Raised JVP

Peripheral cyanosis

Question 2

What are the clinical signs of SVCO?

Answer 2

Face & arm swelling (odema)

Plethora (red face)

Raised JVP
Peripheral cyanosis

Question 3

What are causes of SVCO?

Answer 3

Lung cancer

Lymphoma

Metastases

SVC thrombosis

Question 4

What investigations should you do for SVCO?

Answer 4

Bloods

CXR

Biopsy of mass (if present)

Superior venocavagram

Bronchoscopy (for lung cancer)

CT

Question 5

What investigatio should you do for staging SVCO?

Answer 5

CT

Question 6

What investigation should you do for SVCO if lung cacner is the likely cause?

Answer 6

Bronchoscopy

Question 7

How is SVCO treated?

Answer 7

Dexamtheasone (reduces sweeling)

Omeprazole (gastic protection)

Chemotherapy

Radiotherapy

Question 8

Dexamathasone is a steroid used to treat SVCO, what else should you give along side it and why?

Answer 8

Omperazole

To provide gastric protection

Question 9

What should you ask the patient to do in the inital management of SVCO?

Answer 9

Sit up

Odema is worse when supine

Question 10

What do you need to consider before using chemo to treat SVCO?

Answer 10

Tumour type

Extent of disease

Previous treatment