Superior Venal Caval Obstruction

Question 1

What is the cause of this condition?

Answer 1

Bronchogenic carcinoma - small cell Lung Ca
Lymphoma
Metastatic tumors
SVC thrombosis and mediastinal fibrosis

Question 2

What re the 4 main features of this condition?

Answer 2

Facial swelling and fullness of the head
Arm swelling
Dysphagia and dyspnoea
Weight loss and anorexia

Question 3

What are the examination findings?

Answer 3

Distention of neck and chest wall veins
Fixed (i.e. non-pulsatile) elevated JVP
Facial oedema/puffiness
Oedema of the arms
Plethora of face
Peripheral cyanosis

Question 4

What are the 5 main investigations?

Answer 4

If new presentation of malignancy then station, biopsy etc
CXR
CT
Superior venogram
Bronchoscopy if primary lung cancer suspected

Question 5

What are the management options? (5)

Answer 5

Sterior and supportive
Radio/chemotherapy
Stenting of SVC for benign cuases
Thrombolysis and anticoagulation if thrombosis of SVC
Remove catheter if catheter induced SVC thrombosis