Emergency Department Diagnosis and Management of Superior Vena Cava Syndrome Secondary to Hodgkin’s Lymphoma: Case Report and Limited Literature Review of Emergency Department Management.
Superior vena cava syndrome is an uncommon condition seen in the emergency department. There are limited case reports and literature reviews. Because of more sophisticated imaging technologies and medical care, emergency physicians now
rarely see advanced cases of SVC and may be less familiar with the presentation and initial management.
Classic SVC syndrome presents with chest pain, shortness of breath, facial and neck plethora, prominent neck veins, collateralized chest wall veins, and a cyanotic appearance of skin with an area of demarcation at the lower chest. Up to 85% of SVC syndromes are due to a malignant process with the most common being small-cell lung cancer.
Superior vena cava syndrome requires rapid assessment and management. Untreated SVC syndrome may lead to life-threatening cerebral and laryngeal edema. A 26-year-old male construction worker presented to the ED with a complaint of chest pain and shortness of breath that was present and worsening for approximately 5 weeks.
The pain localized over the right upper chest region was described as intermittent and pressure-like. Any time the patient walked more than forty yards he reported feeling presyncopal. He also reported that
he would become lightheaded and pale when working out in the heat.
Additionally, a work colleague noticed that with prolonged exposure to heat spider veins over his chest became prominent
with demarcated rash at the level of the diaphragm.
Emerg Med Open J. 2023; 9(2): 33-38. doi: 10.17140/EMOJ-9-171
