Superior vena cava syndrome natural history, complications and prognosis

Superior Vena Cava Syndrome Microchapters
Home
Patient Information
Overview
Historical Perspective
Pathophysiology
Causes
Differentiating Superior Vena Cava Syndrome from Other Diseases
Epidemiology and Demographics
Risk Factors
Screening
Natural History, Complications and Prognosis
Diagnosis
Staging
History and Symptoms
Physical Examination
Laboratory Findings
Chest X Ray
CT
MRI
Ultrasound
Other Imaging Findings
Other Diagnostic Studies
Treatment
Medical Therapy
Radiation Therapy
Surgery
Primary Prevention
Cost-Effectiveness of Therapy
Future or Investigational Therapies
Case Studies
Case #1
Superior vena cava syndrome natural history, complications and prognosis On the Web
Most recent articles
Most cited articles
Review articles
CME Programs
Powerpoint slides
Images
American Roentgen Ray Society Images of Superior vena cava syndrome natural history, complications and prognosis All Images X-rays Echo & Ultrasound CT Images MRI
Ongoing Trials at Clinical Trials.gov
US National Guidelines Clearinghouse
NICE Guidance
FDA on Superior vena cava syndrome natural history, complications and prognosis
CDC on Superior vena cava syndrome natural history, complications and prognosis
Superior vena cava syndrome natural history, complications and prognosis in the news
Blogs on Superior vena cava syndrome natural history, complications and prognosis
Directions to Hospitals Treating Superior vena cava syndrome
Risk calculators and risk factors for Superior vena cava syndrome natural history, complications and prognosis

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.

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:

• 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 rapid 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.
• 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 symptoms because there is a presence of collateral veins that compensate increased flow.
• 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%.
• 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.