What are the symptoms of superior vena cava compression syndrome

The symptoms of superior vena cava compression sign mainly include difficulty breathing, facial and neck swelling, cough, headache, chest pain, etc. Superior vena cava compression sign is usually caused by mediastinal tumors, lymphoma, thrombosis, and other factors, and may be accompanied by symptoms such as upper limb edema and hoarseness. It is recommended to seek medical attention promptly and receive targeted treatment after identifying the cause.

1. Dyspnea

Dyspnea is a typical manifestation of superior vena cava compression syndrome, which is caused by obstruction of superior vena cava return, leading to an increase in intrathoracic venous pressure and affecting pulmonary blood circulation. The patient may experience difficulty breathing, shortness of breath, and worsening symptoms when lying flat. Tumor compression or thrombus formation are common causes that require clear diagnosis through imaging examinations. Treatment requires the release of compressive factors, such as radiation therapy or surgery.

2. Facial and neck swelling

Facial and neck swelling is characterized by tight and shiny skin on the eyelids, cheeks, and neck, particularly evident in the morning. This is a direct result of venous reflux obstruction in the head and neck region after compression of the superior vena cava. Swelling may be accompanied by skin cyanosis or superficial venous dilation. Clinically, it is necessary to differentiate it from kidney disease or allergic reactions, and enhanced CT can display the site of vascular compression.

3. Cough

Persistent dry cough or irritating cough may be related to tracheal compression or pulmonary congestion. Tumor growth can compress the trachea or superior vena cava, leading to bronchial mucosal edema, which can cause coughing. Coughing often worsens at night and may be accompanied by bloody phlegm. Bronchoscopy examination helps to determine the degree of airway compression, and glucocorticoids can temporarily alleviate edema symptoms.

4. Headache

Head swelling and pain are often caused by increased cerebral venous pressure due to obstruction of intracranial venous return. Pain is often persistent dull pain that intensifies when bending over or exerting force, and may be accompanied by blurred vision or tinnitus. This type of headache has a poor response to ordinary painkillers, and reducing intracranial pressure treatment is more effective. Be alert to serious complications such as venous sinus thrombosis.

5. Chest pain

The dull or oppressive feeling behind the sternum is often caused by compression of the mediastinal structure or myocardial ischemia. Superior vena cava hypertension may reduce coronary artery blood reflux and cause atypical angina. The pain can radiate to the shoulders and back, and is not related to respiratory movements. Electrocardiogram and myocardial enzyme examination can help rule out primary heart disease, and treatment should focus on venous compression itself. When symptoms of superior vena cava compression appear, vigorous activity and bending movements should be avoided. Raising the head of the bed during sleep can help reduce venous congestion. Restricting sodium intake can alleviate edema, but it is necessary to ensure sufficient protein nutrition. All patients need to complete chest CT or MRI examinations as soon as possible, and malignant tumor patients need to be evaluated for tumor staging simultaneously. Regularly monitor changes in upper limb venous pressure during treatment to be alert to complications such as thromboembolism.