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Superior Vena Cava Syndrome

Medically reviewed by Last updated on Oct 3, 2022.

What is superior vena cava syndrome?

Superior vena cava syndrome (SVCS) develops when your superior vena cava is partially or fully blocked. Your superior vena cava is a large blood vessel. Blood from your upper body normally flows through the superior vena cava and into the right side of your heart. Your heart then pumps the blood to your lungs. A partially or fully blocked superior vena cava causes blood to remain in blood vessels in and around your heart. Without treatment, SVCS may become life-threatening.

What increases my risk for SVCS?

  • Cancer
  • A tumor
  • A blood clot
  • A previous pacemaker, catheter, or central line placement
  • Certain fungal or bacterial infections

What are the signs and symptoms of SVCS?

  • Swelling in your face or neck
  • Swelling in your right arm
  • Bulging veins in your neck or chest
  • Difficulty breathing, especially when you are lying down or bending forward
  • Chest pain or difficulty swallowing
  • Headache or vision problems
  • Blue or purple skin on the right side of your body

How is SVCS diagnosed?

A CT or MRI scan may be used to take pictures of the organs in your chest. You may be given dye to help the organs show up better in the pictures. Tell the healthcare provider if you have ever had an allergic reaction to contrast dye. Do not enter the MRI room with anything metal. Metal can cause serious injury. Tell the healthcare provider if you have any metal in or on your body.

How is SVCS treated?

Treatment is based on the severity of your symptoms and the underlying cause of your SVCS. You may need any of the following:

  • Medicines:
    • Steroids decrease inflammation.
    • Diuretics decrease swelling.
    • Blood thinners help prevent blood clots. Clots can cause strokes, heart attacks, and death. The following are general safety guidelines to follow while you are taking a blood thinner:
      • Watch for bleeding and bruising while you take blood thinners. Watch for bleeding from your gums or nose. Watch for blood in your urine and bowel movements. Use a soft washcloth on your skin, and a soft toothbrush to brush your teeth. This can keep your skin and gums from bleeding. If you shave, use an electric shaver. Do not play contact sports.
      • Tell your dentist and other healthcare providers that you take a blood thinner. Wear a bracelet or necklace that says you take this medicine.
      • Do not start or stop any other medicines unless your healthcare provider tells you to. Many medicines cannot be used with blood thinners.
      • Take your blood thinner exactly as prescribed by your healthcare provider. Do not skip does or take less than prescribed. Tell your provider right away if you forget to take your blood thinner, or if you take too much.
      • Warfarin is a blood thinner that you may need to take. The following are things you should be aware of if you take warfarin:
        • Foods and medicines can affect the amount of warfarin in your blood. Do not make major changes to your diet while you take warfarin. Warfarin works best when you eat about the same amount of vitamin K every day. Vitamin K is found in green leafy vegetables and certain other foods. Ask for more information about what to eat when you are taking warfarin.
        • You will need to see your healthcare provider for follow-up visits when you are on warfarin. You will need regular blood tests. These tests are used to decide how much medicine you need.
    • Fibrinolytics break up blood clots.
  • Treatment:
    • Chemotherapy shrinks the tumor that causes blockage.
    • Stenting opens your superior vena cava so blood can flow through.
    • Surgical bypass routes the blood through a different blood vessel.

What are the risks of SVCS?

Even with treatment, your symptoms may return. If your SVCS is severe, swelling of your brain or throat may cause death. The blocked superior vena cava causes blood to remain in your blood vessels. This increases your risk for blood clots. Left untreated, SVCS can be life-threatening.

How do I manage my symptoms?

  • Limit liquids and sodium (salt). Too much liquid or salt may cause more swelling and increase your blood pressure. Ask your healthcare provider how much liquid to drink each day and which liquids are best for you. Ask how much salt is safe for you to have each day.
  • Elevate your upper body. Sleep upright to decrease pressure caused by swelling.

When should I contact my healthcare provider?

  • Your symptoms return.
  • You have questions or concerns about your condition or care.

When should I seek immediate care or call 911?

  • You have new or worsening shortness of breath.
  • You hear a rasping sound when you breathe.
  • You have increased dizziness or confusion.
  • You have a seizure.
  • You lose consciousness.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your healthcare providers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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