Content provided by Sean M. Fox and EMGuideWire Team - From Carolinas Medical Center Emergency Medicine Residen. All podcast content including episodes, graphics, and podcast descriptions are uploaded and provided directly by Sean M. Fox and EMGuideWire Team - From Carolinas Medical Center Emergency Medicine Residen or their podcast platform partner. If you believe someone is using your copyrighted work without your permission, you can follow the process outlined here https://player.fm/legal.
Player FM - Podcast App
Go offline with the Player FM app!
Go offline with the Player FM app!
SVC Syndrome
MP3•Episode home
Manage episode 270758030 series 2783208
Content provided by Sean M. Fox and EMGuideWire Team - From Carolinas Medical Center Emergency Medicine Residen. All podcast content including episodes, graphics, and podcast descriptions are uploaded and provided directly by Sean M. Fox and EMGuideWire Team - From Carolinas Medical Center Emergency Medicine Residen or their podcast platform partner. If you believe someone is using your copyrighted work without your permission, you can follow the process outlined here https://player.fm/legal.
Join the EMGuideWire team as they discuss Superior Vena Cava Syndrome!
Shownotes:
Definition:
- Any condition leading to obstruction of blood flow through the SVC
Pathophysiology:
- Pathology in adjacent anatomy (lung, lymph node, thymus, mediastinum) or within the SVC itself obstructs venous return to the right atrium. As the SVC is compressed, venous collaterals form alternative pathways returning blood to the right atrium which can dilate over several weeks. As a result, upper body venous pressure increases, which in extreme cases lead to airway congestion and venous cerebrovascular congestion and edema. Hemomdynamic compromise is most often by direct compression of the heart, not from SVC obstruction.
Risk factors:
- Indwelling device through the SVC (Central line, dialysis catheter, pacemaker)
- Lung cancer
- Lymphoma
- Thymoma
Presentation:
- Signs – plethoric appearance, dilated neck and chest veins, swollen face/neck/chest
- Symptoms – congestive symptoms (head fullness, swelling), cardiopulmonary symptoms (chest pain, dyspnea, stridor, hoarseness), and neurologic symptoms (headache, confusion, obtundation, visual disturbances)
Work-up:
- Is the patient unstalbe? Do they have severe SVC?
- If yes, secure airway, support breathing, support circulation
- Consult vascular/cardiothoracic surgery
- If patient is stable, then:
- Confirm diagnosis and evaluate for malignant obstruction
- CBC, CMP, PT/INR, CXR, CT chest w/contrast
- Does the patient have a malignant obstruction or thrombosis?
- Yes -> consult heme/onc and admit
- No -> observe in ED
- Confirm diagnosis and evaluate for malignant obstruction
References:
100 episodes
MP3•Episode home
Manage episode 270758030 series 2783208
Content provided by Sean M. Fox and EMGuideWire Team - From Carolinas Medical Center Emergency Medicine Residen. All podcast content including episodes, graphics, and podcast descriptions are uploaded and provided directly by Sean M. Fox and EMGuideWire Team - From Carolinas Medical Center Emergency Medicine Residen or their podcast platform partner. If you believe someone is using your copyrighted work without your permission, you can follow the process outlined here https://player.fm/legal.
Join the EMGuideWire team as they discuss Superior Vena Cava Syndrome!
Shownotes:
Definition:
- Any condition leading to obstruction of blood flow through the SVC
Pathophysiology:
- Pathology in adjacent anatomy (lung, lymph node, thymus, mediastinum) or within the SVC itself obstructs venous return to the right atrium. As the SVC is compressed, venous collaterals form alternative pathways returning blood to the right atrium which can dilate over several weeks. As a result, upper body venous pressure increases, which in extreme cases lead to airway congestion and venous cerebrovascular congestion and edema. Hemomdynamic compromise is most often by direct compression of the heart, not from SVC obstruction.
Risk factors:
- Indwelling device through the SVC (Central line, dialysis catheter, pacemaker)
- Lung cancer
- Lymphoma
- Thymoma
Presentation:
- Signs – plethoric appearance, dilated neck and chest veins, swollen face/neck/chest
- Symptoms – congestive symptoms (head fullness, swelling), cardiopulmonary symptoms (chest pain, dyspnea, stridor, hoarseness), and neurologic symptoms (headache, confusion, obtundation, visual disturbances)
Work-up:
- Is the patient unstalbe? Do they have severe SVC?
- If yes, secure airway, support breathing, support circulation
- Consult vascular/cardiothoracic surgery
- If patient is stable, then:
- Confirm diagnosis and evaluate for malignant obstruction
- CBC, CMP, PT/INR, CXR, CT chest w/contrast
- Does the patient have a malignant obstruction or thrombosis?
- Yes -> consult heme/onc and admit
- No -> observe in ED
- Confirm diagnosis and evaluate for malignant obstruction
References:
100 episodes
All episodes
×Welcome to Player FM!
Player FM is scanning the web for high-quality podcasts for you to enjoy right now. It's the best podcast app and works on Android, iPhone, and the web. Signup to sync subscriptions across devices.