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==Overview==
==Overview==
If left untreated, [[Patient|patients]] with [[superior vena cava syndrome]] may progress to develop a complete [[blood]] flow obstruction and a decreased [[cardiac output]] with [[hypotension]], leading to [[heart failure]] and death. Common [[Complication (medicine)|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 [[Patient|patients]] with [[superior vena cava syndrome]] is approximately 10-20% at 6 months.<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>


If left untreated, patients with SVCS may progress to a potentially life-threatening situation and death. Common complications of superior vena cava syndrome include airway obstruction and increased [[ICP]]. 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.
==Natural History==
If left untreated, [[Patient|patients]] with [[superior vena cava syndrome]] may progress to develop a complete [[blood flow]] [[obstruction]] and a decreased [[Cardiac output|cardiac outpu]]<nowiki/>t 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]].


==Complications==
==Complications==
*The [[throat]] could become blocked, which can block the airways.
 
*Increased pressure may develop in the [[brain]], leading to changed levels of [[consciousness]], [[nausea]], [[vomiting]], or vision changes.
[[Complications]] that can develop as a result of [[superior vena cava syndrome]] are the following:<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>
*[[Airway obstruction]]
*[[Laryngeal edema]]
*[[Cerebral edema]]
*Decreased [[cardiac output]] with [[hypotension]]
*[[Pulmonary embolism]]


==Prognosis==
==Prognosis==
*The outcome varies depending on the cause and the amount of blockage.
 
*SVCS caused by a [[tumor]] is a sign that the tumor has spread, and it indicates a poorer long-term outlook.
*The [[prognosis]] of [[superior vena cava syndrome]] is good with treatment.  
*[[Cancer]] patients diagnosed with SVCS do not die of the syndrome itself but rather from the extent of their underlying disease.
*Without [[Treatment IND|treatment]], [[superior vena cava syndrome]] will result in a rapid clinical evolution associated with a 10-20% [[mortality]] within 6 months.  
*SVCS is usually a sign of locally advanced [[bronchogenic carcinoma]]. Survival depends on the status of the patient’s disease. When small cell [[bronchogenic carcinoma]] is treated with [[chemotherapy]], the 24-month survival rate is 9% in patients without SVCS and 3% in those with the syndrome. When the [[malignancy]] is treated with radiation therapy, 46% of patients who have non-small cell [[lung cancer]] experience relief of symptoms compared with 62% of patients who have small cell [[bronchogenic carcinoma]]. The 2-year survival rate of 5% is almost the same for both groups.
*The presence of [[Malignancies|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>
*Most [[non-Hodgkin lymphoma]] patients with SVCS respond to appropriate [[chemotherapy]] or to combined modality regimens.
*[[Prognosis]] is also associated with the acute or gradual 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.  
*Chronic onset is related with less severe [[Symptom|symptoms]] because there is a presence of [[Vein|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 [[superior vena cava syndrome]], the 2-year [[survival rate]] is 3%.  
*[[Patient|Patients]] 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==
{{Reflist|2}}
{{Reflist|2}}


[[Category:Needs content]]
[[Category:Disease]]
[[Category:Disease]]
[[Category:Otolaryngology]]
[[Category:Hematology]]
[[Category:Hematology]]
[[Category:Cardiology]]
[[Category:Cardiology]]

Latest revision as of 13:46, 12 April 2019

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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 blood flow 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 superior vena cava syndrome is approximately 10-20% at 6 months.[1]

Natural History

If left untreated, patients with superior vena cava syndrome may progress to develop a complete blood flow 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.

Complications

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

Prognosis

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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