[ICD-associated superior vena cava syndrome]

Area of Science:

• Cardiology
• Radiology
• Oncology

Background:

• Superior vena cava (SVC) syndrome results from obstructed blood flow in the SVC, leading to characteristic symptoms like facial and neck swelling.
• While malignancy is the most common cause, iatrogenic factors, including central venous catheters and cardiac devices, are rising.
• SVC syndrome is a critical differential diagnosis for angioedema, often leading to misdiagnosis.

Purpose of the Study:

• To highlight the diagnostic challenges of iatrogenic Superior vena cava (SVC) syndrome.
• To emphasize the importance of considering SVC syndrome in patients with relevant risk factors and symptoms.
• To underscore the need for increased clinical awareness and diagnostic vigilance.

Main Methods:

• Case report of a patient with iatrogenic SVC syndrome who experienced multiple misdiagnoses.
• Review of clinical presentation, diagnostic workup, and management of SVC syndrome.
• Contrast-enhanced computed tomography (CT) as the primary diagnostic tool.

Main Results:

• The case illustrates how SVC syndrome can be misdiagnosed, delaying appropriate treatment.
• Iatrogenic causes of SVC syndrome are becoming more prevalent.
• Accurate diagnosis requires a high index of suspicion and comprehensive evaluation.

Conclusions:

• Increased knowledge of SVC syndrome and its varied etiologies is essential for clinicians.
• A thorough physical examination and readiness to reconsider the diagnosis are paramount to avoid misdiagnosis.
• Early and accurate diagnosis of SVC syndrome improves patient outcomes.