Clinical management of superior vena cava syndrome

SVCS is a relative medical emergency because it is usually the result of partial or complete occlusion of the SVC by a malignant tumor. Obstruction of the SVC is mimicked by few other organic problems. The traditional view of therapy protocols is that treatment can and should be started before an etiologic diagnosis is made. More recent literature holds that difficulties arise when treatment is started before a cause and location are known. The therapy of choice for this localized problem is radiation therapy. High-dose, short-interval radiation is the primary treatment around which diuretics, steroids, and anticoagulants are added as adjuvants. Most patients treated with radiation therapy respond subjectively within 72 hours and show objective signs of relief within 7 days. The overall survival rate is dependent on the underlying malignancy. Nursing care focuses on the early detection of symptoms of SVCS and the emergency nature of the acute phase. Side effects of therapy and nursing care needs result from therapy as well as from the underlying disease. The psychosocial stressors on the patient and the family are an integral part of the nursing care. The goals of nursing management are good supportive care, astute assessment, and monitoring of the patient's condition. Finally, SVCS is a relative medical emergency. This entity has been described for many years, but it is often misunderstood and mismanaged. The goal of medical management is a rapid diagnostic work-up and the administration of palliative radiation therapy to alleviate the symptoms.(ABSTRACT TRUNCATED AT 250 WORDS)