Superior Vena Cava Syndrome

Approved by the Cancer.Net Editorial Board, 07/2018

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.

SVCS should be treated seriously. Treatment to relieve symptoms and side effects, such as SVCS, is an important part of cancer care. This approach is called palliative care or supportive care. Talk with your health care team about any symptoms you experience. This should include any new symptoms or a change in symptoms.

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. The cancer can cause SVCS in several 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.

  • Cancer can spread to the lymph nodes surrounding the superior vena cava. Then the lymph nodes may enlarge and press on or block the vein.

  • Cancer may cause a blood clot in the vein. A blood clot may also be caused by a pacemaker wire or an intravenous catheter. An intravenous catheter is a flexible tube that is placed in a vein to take out or put in fluids.

Symptoms of superior vena cava syndrome

SVCS is a group of symptoms that usually develop slowly. This condition causes serious breathing problems and is an emergency. Although SVCS and its symptoms are serious, most people respond well to treatment.

Call your doctor immediately If you have any of the symptoms described below.

Common symptoms of SVCS include:

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

  • Trouble breathing or shortness of breath

  • Coughing

Rare symptoms of SVCS include:

  • Hoarseness in voice

  • Chest pain

  • Trouble 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. But it is more common for a blockage to develop slowly. If this is the case, then other veins may enlarge to carry extra blood. In these situations, the symptoms may be milder.

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 person's vein

  • Ultrasound

Learn more about these tests and procedures.

Managing superior vena cava syndrome

Sometimes, people with SVCS may not need treatment for the condition right away. For example, the symptoms may be mild, the trachea may not be blocked, and blood may be flowing well through other veins in the chest.

SVCS can be managed with chemotherapy or radiation therapy given to treat the cancer causing the side effect. Other short-term treatments can help reduce symptoms of SVCS, including:

  • Raising the person'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

  • Receiving 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. But 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 right away.

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 in voice

  • Trouble breathing

  • Chest pain 

Related Resources

Heart Problems

More Information

National Cancer Institute: Cardiopulmonary Syndromes