SVC Syndrome (Oncologic Emergencies)

An overview of the clinical presentation, etiologies, diagnosis, and treatment of the superior vena cava syndrome - a serious complication of non-small cell and small cell lung cancers, among other conditions.
CT images of SVC compression and thrombosis both courtesy of Dr Hani Makky Al Salam, Radiopaedia.org, rID: 13267
Chest X-ray of SVC stent courtesy of Dr Henry Knipe, Radiopaedia.org, rID: 31410
#oncology

[@VyewVyew]

Thanks Dr Strong for another great video! From personal experience I also want to add that
1) for Pemberton's sign, the patient may actually tell you they feel like they are suffocating the longer they hold their arms up
2) if the patient has already been on high dose steroids for other complications of their cancer (e.g. lymphangitic carcinomatosis, MSCC) then they may already be plethoric and have Cushingoid facies which can cause overlooking of the SVCO facial oedema
3) Dilated collateral superficial chest wall veins! Have fond memories of being asked to take "difficult bloods" from a previous IVDU SVCO patient but we mutually decided I would just phlebotomise one of his numerous extremely dilated collateral chest veins. He thought the explanation of his entire (upper) body being tourniquet'd by his cancer was quite amusing. He did much better after a SVC stent such that all of his collateral chest veins collapsed within a few days of the stent placement and he lost his Pemberton's sign!

[@StrongMed]

Excellent pearls! Thank you for the comment!

[@LenoraRogers]

I get short of breath when bending over.

[@LenoraRogers]

Great video. Maybe there is help for me
😅

[@fabiogoden3757]

You are amazing. Just remember that

[@sunving]

Thank you Doctor !

[@DwayneBellwashere]

Thank you for illuminating the differences in skin tone alteration amongst different individuals. 0:44

[@jeanwillis7774]

I want to take this opportunity Dr Strong,to congratulate you on a excellent medical series.It’s informative,intelligent &concise.Thank you from Ontario 🇨🇦

[@LenoraRogers]

I came home 5th attempt to put stent in. 9my cause of SVC from me was undiagnosed with a lot of clots that were old. the 5th attempt and was told veins. we're like concrete. is there any helpl😅😅

[@LenoraRogers]

my sbc syndrome was because by old clots to vein. in upper chest 5 attempts were unsuccessful all doctors said it was like trying to get a needle through concrete. is there

[@thanhphucle8097]

hayyy