Superior Vena Cava Syndrome

Approved by the Cancer.Net Editorial Board, 01/2017

The superior vena cava is a major vein in a person’s body. It carries blood from the head, neck, upper chest, and arms to the heart. Superior vena cava syndrome (SVCS) occurs when a person’s superior vena cava is partially blocked or compressed. Cancer is usually the main cause of SVCS.

Relieving side effects such as SVCS is an important part of cancer care and treatment. This is called symptom management or palliative care. Talk with your health care team about any new symptoms or changes in symptoms you experience.

Symptoms of superior vena cava syndrome

SVCS is a group of symptoms that usually develop slowly. Because SVCS can cause serious breathing problems, it is an emergency. If you experience any of the symptoms listed below, contact your doctor immediately. Although SVCS and its symptoms are serious, treatment works well for most people.

Common symptoms of SVCS include:

  • Difficulty breathing or shortness of breath

  • Coughing

  • Swelling of the face, neck, upper body, and arms

Rare symptoms of SVCS include:

  • Hoarseness

  • Chest pain

  • Difficulty swallowing

  • Coughing up blood from the lungs and throat

  • Swelling of the veins in the chest and neck

  • Fluid buildup in the arms

  • Faster breathing

  • Bluish skin from a lack of oxygen

  • Vocal cord paralysis

  • Horner's syndrome, which includes a constricted pupil, sagging eyelid, and lack of sweat on one side of the face

SVCS may develop quickly and completely block the airway. When this occurs, a person may need a ventilator to help with breathing until the blockage is treated. More commonly, if the blockage develops slowly, other veins may enlarge to carry extra blood. In these situations, the symptoms may be milder.

Causes of superior vena cava syndrome

SVCS is more common for people who have lung cancer, non-Hodgkin lymphoma, or cancers that spread to the chest. But cancer can cause SVCS in other ways:

  • A tumor in the chest may press on the superior vena cava.

  • A tumor may grow into the superior vena cava, causing a blockage.

  • If cancer spreads to the lymph nodes surrounding the superior vena cava, the lymph nodes may enlarge and press on or block the vein.

  • A blood clot may appear in the vein. This is caused by a pacemaker wire or an intravenous catheter, which is a flexible tube placed in a vein to take out or put in fluids

Diagnosing superior vena cava syndrome

The following tests will help your doctor diagnose SVCS:

  • Chest x-ray

  • Computed tomography (CT) scan

  • Magnetic resonance imaging (MRI)

  • Venography, which is an x-ray done after injecting a special dye into the patient’s vein

  • Ultrasound

Learn more about these tests and procedures.

Managing superior vena cava syndrome

Sometimes, people with SVCS may not need treatment until SVCS is diagnosed. Or they may not need treatment right away. This depends on whether the symptoms are mild, the trachea is not blocked, and blood is flowing well through other veins in the chest.

Managing SVCS includes chemotherapy or radiation therapy to treat the cancer causing SVCS. Other short-term treatments can help reduce symptoms of SVCS, including:

  • Raising the patient’s head

  • Giving corticosteroids, which are medications that reduce swelling

  • Using diuretics, which are medications that eliminate excess fluid from the body by increasing urination

  • Undergoing thrombolysis, a treatment to break up a blood clot in the vein

  • Inserting a tube-like device, called a stent, into the blocked area of the vein so blood can pass through

  • Using surgery to bypass a blockage

Superior vena cava syndrome in children

SVCS is rare in children. However, SVCS in children can be life threatening. If your child has signs of SVCS, it is important to contact your child’s health care team immediately.

A child's trachea is smaller and softer than an adult's trachea. This means that it can swell or become constricted quickly and cause breathing problems.

Common childhood SVCS symptoms are similar to what adults experience and may include:

  • Coughing

  • Hoarseness

  • Difficulty breathing

  • Chest pain

More Information

Side Effects

Heart Problems

Additional Resource

National Cancer Institute: Cardiopulmonary Syndromes