Superior vena cava syndrome natural history, complications and prognosis: Difference between revisions

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==Prognosis==
==Prognosis==


The prognosis of superior vena cava syndrome is good with treatment. Without treatment, superior vena cava syndrome will result in a torpid clinical evolution associated with a 10- 20% mortality within 6 months. The presence of thoracic malignancies is associated with a particularly poor prognosis among patients with superior vena cava syndrome.<ref name="pmid16502166">{{cite journal |vauthors=Uberoi R |title=Quality assurance guidelines for superior vena cava stenting in malignant disease |journal=Cardiovasc Intervent Radiol |volume=29 |issue=3 |pages=319–22 |year=2006 |pmid=16502166 |doi=10.1007/s00270-005-0284-9 |url=}}</ref>
The prognosis of superior vena cava syndrome is good with treatment. Without treatment, superior vena cava syndrome will result in a torpid clinical evolution associated with a 10-20% mortality within 6 months. The presence of thoracic malignancies is associated with a particularly poor prognosis among patients with superior vena cava syndrome.<ref name="pmid16502166">{{cite journal |vauthors=Uberoi R |title=Quality assurance guidelines for superior vena cava stenting in malignant disease |journal=Cardiovasc Intervent Radiol |volume=29 |issue=3 |pages=319–22 |year=2006 |pmid=16502166 |doi=10.1007/s00270-005-0284-9 |url=}}</ref>


Prognosis is also associated with the acute or long onset of the disease. Acute onset, is relate with more severe symptoms because of absent collateral vein. Therefore there is no distention to accommodate an increased blood flow. However, chronic onset is related with less severe symptoms because there is a presence of collateral veins that compensate increased flow.<ref name="pmid17476012">{{cite journal |vauthors=Wilson LD, Detterbeck FC, Yahalom J |title=Clinical practice. Superior vena cava syndrome with malignant causes |journal=N. Engl. J. Med. |volume=356 |issue=18 |pages=1862–9 |year=2007 |pmid=17476012 |doi=10.1056/NEJMcp067190 |url=}}</ref>
Prognosis is also associated with the acute or long onset of the disease. Acute onset, relates with more severe symptoms because of absent collateral veins. Therefore there is no distention to accommodate the increased blood flow. On the other hand, chronic onset is related with less severe symptoms because there is a presence of collateral veins that compensate increased flow.<ref name="pmid17476012">{{cite journal |vauthors=Wilson LD, Detterbeck FC, Yahalom J |title=Clinical practice. Superior vena cava syndrome with malignant causes |journal=N. Engl. J. Med. |volume=356 |issue=18 |pages=1862–9 |year=2007 |pmid=17476012 |doi=10.1056/NEJMcp067190 |url=}}</ref>
 
Patients with small cell [[bronchogenic carcinoma]] treated with chemotherapy and that simultaneously course with SVCS, the 2-year survival rate is 3%. Whereas, those treated with radiation therapy, the relief of symptoms is greater, however the 2-year survival rate of ˜5% is almost the same for both groups.<ref name="pmid17476012">{{cite journal |vauthors=Wilson LD, Detterbeck FC, Yahalom J |title=Clinical practice. Superior vena cava syndrome with malignant causes |journal=N. Engl. J. Med. |volume=356 |issue=18 |pages=1862–9 |year=2007 |pmid=17476012 |doi=10.1056/NEJMcp067190 |url=}}</ref>


==References==
==References==

Revision as of 18:16, 13 January 2016

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Maria Fernanda Villarreal, M.D. [2]

Overview

If left untreated, patients with superior vena cava syndrome may progress to develop a complete obstruction and a decreased cardiac output with hypotension, leading to heart failure and death. Common complications of superior vena cava syndrome include airway obstruction, increased ICP, laryngeal edema and cerebral edema. The prognosis will vary depending on the cause of the syndrome, and the amount of blockage that has already occurred. Prognosis is generally poor, and the survival rate of patients with SVCS is approximately 10-20% at 6 months.[1]

Complications

Complications that can develop as a result of superior vena cava syndrome are, the following:[1]

  • Airway obstruction
  • Laryngeal edema
  • Cerebral edema
  • Decreased cardiac output with hypotension
  • Pulmonary embolism

Prognosis

The prognosis of superior vena cava syndrome is good with treatment. Without treatment, superior vena cava syndrome will result in a torpid clinical evolution associated with a 10-20% mortality within 6 months. The presence of thoracic malignancies is associated with a particularly poor prognosis among patients with superior vena cava syndrome.[2]

Prognosis is also associated with the acute or long onset of the disease. Acute onset, relates with more severe symptoms because of absent collateral veins. Therefore there is no distention to accommodate the increased blood flow. On the other hand, chronic onset is related with less severe symptoms because there is a presence of collateral veins that compensate increased flow.[1]

Patients with small cell bronchogenic carcinoma treated with chemotherapy and that simultaneously course with SVCS, the 2-year survival rate is 3%. Whereas, those treated with radiation therapy, the relief of symptoms is greater, however the 2-year survival rate of ˜5% is almost the same for both groups.[1]

References

  1. 1.0 1.1 1.2 1.3 Wilson LD, Detterbeck FC, Yahalom J (2007). "Clinical practice. Superior vena cava syndrome with malignant causes". N. Engl. J. Med. 356 (18): 1862–9. doi:10.1056/NEJMcp067190. PMID 17476012.
  2. Uberoi R (2006). "Quality assurance guidelines for superior vena cava stenting in malignant disease". Cardiovasc Intervent Radiol. 29 (3): 319–22. doi:10.1007/s00270-005-0284-9. PMID 16502166.

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