Superior Vena Cava Obstruction (SVCO)
SVCO is nearly always associated with malignancy. It is an oncological emergency that may occur as a result of disease progression of a known cancer, but can be the presenting feature of a new cancer diagnosis.
Initial assessment
Signs and Symptoms:
- Dyspnoea and tachypnoea,
- Stridor – due to laryngeal oedema,
- Thoracic and neck veins distention,
- Facial/neck/arm swelling,
- Plethora,
- Non-pulsatile JVP,
- Central/peripheral cyanosis,
- Chest pain,
- Cough
- Headaches and/or confusion,
- Hoarse voice,
- Coma
Questions:
- Does the patient has cancer diagnosis?
- Cardinal questions related to breathlessness including history of underlying chest complaints
- Differential diagnosis would include chest infection, PE, disease progression, ascending aortic aneurysm
Observation:
Temperature, blood pressure, heart rate, respiratory rate, saturation of oxygen, nEWS score
Investigations:
- FBC, clotting, U&Es,
- CXR,
- Chest CT
