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Thursday, 1 September 2016

Superior Vena Cava (SVC) obstruction Self Assessment Questions

Q1  What's the most common cause of SVC obstruction?

Q2  How can you link between SVC obstruction and proteinuria?

Q3  Which clinical test can help in suspecting the diagnosis of SVC obstruction?

Q4  What characterizes jugular venous pulse (JVP) in SVC obstruction ?

Q5  What's the best therapeutic option for rapid relief of obstruction?

Check for the answers below

A1  Malignancy is the cause in more than 90% of cases (commonly, bronchogenic carcinoma).

A2  Nephrotic syndrome predisposes to SVC thrombosis and occlusion, though its very uncommon cause.

A3  Pembertons test.
Ask the patient to lift his/her arms over the head for at least one minute. This can result in  facial plethora and cyanosis.

A4  JVP in SVC obstruction is non-pulsatile.

A5  SVC stenting or balloon dilatation (venoplasty).

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