Pathophysiology

The SVC is the primary drainage vein for blood return from the head, neck, and upper extremities. It is a relatively thin-walled vein that is particularly vulnerable to obstruction from adjacent tumor invasion or thrombosis. The obstruction leads to elevated venous pressure, although collateral veins partially compensate. This is one reason for the relatively slow onset of the classic symptoms of SVCS. In fact, 75% of patients

have signs and symptoms for more than 1 week before seeking medical attention. clinical presentation and diagnosis

Visible swelling of the face, neck, chest, and upper limbs with obvious venous disten-

tion are the usual presenting symptoms of SVCS. Patients may also report coughing, hoarseness, sleep disturbances, dyspnea, headache, and confusion.3 Diagnosis is made with consideration of these symptoms in conjunction with imaging studies

which show unusual narrowing of the upper airway.

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