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Superior vena cava syndrome (SVCS), is a group of symptoms caused by obstruction of the superior vena cava ("SVC"), a short, wide vessel carrying circulating blood into the heart. The majority of cases are caused by malignant tumors within the mediastinum , most commonly lung cancer and non-Hodgkin's lymphoma , directly compressing or invading ...
The superior vena cava (SVC) is the superior of the two venae cavae, the great venous trunks that return deoxygenated blood from the systemic circulation to the right atrium of the heart. It is a large-diameter (24 mm) short length vein that receives venous return from the upper half of the body, above the diaphragm .
The CAJ is the joint between the superior vena cava and the atrium. The cavoatrial junction (CAJ) is the point at which the superior vena cava meets and melds into the superior wall of the cardiac right atrium. Both the superior and inferior vena cavae enter the right atrium, but only the superior entry is called the cavoatrial junction.
A chest x-ray is performed after insertion to rule out this possibility. The tip of the catheter can also be misdirected into the contralateral (opposite side) subclavian vein in the neck, rather than into the superior vena cava.
A chest X-ray may be performed afterwards to confirm that the line is positioned inside the superior vena cava and no pneumothorax was caused inadvertently. On anteroposterior X-rays, a catheter tip between 55 and 29 mm below the level of the carina is regarded as acceptable placement. [37]
Upper limb venography is indicated in those who has upper limb oedema, to demonstrate site of occlusion and stenosis in the veins, and superior vena cava obstruction. Low osmolar contrast medium with concentration of 300 mg/ml is used. The subject lies down in supine position. An 18G butterfly needle is inserted into the median cubital vein.
A positive Pemberton's sign is indicative of superior vena cava syndrome (SVC), commonly the result of a mass in the mediastinum.Although the sign is most commonly described in patients with substernal goiters where the goiter "corks off" the thoracic inlet, [4] the maneuver is potentially useful in any patient with adenopathy, tumor, or fibrosis involving the mediastinum.
The left superior vena cava is not shown in this image. In anatomy , a persistent left superior vena cava is the most common variation of the thoracic venous system . [ 1 ] [ 2 ] It is present in between 0.3% and 0.5% of the population, [ 3 ] [ 4 ] [ 5 ] and is an embryologic remnant that results from a failure to involute .
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