Superior vena cava (SVC) syndrome is an unusual complication of pacemaker and implantable cardioverter–defibrillator implantation. It is believed to be due to SVC thrombosis with or without stenosis induced by endothelial disruption from repeated mechanical trauma by the leads. A 58-year-old man presented with gradual swelling of his face, neck, and upper extremities of 10 days duration. A pacemaker had been implanted for symptomatic bradycardia over 5 years ago. Venous Doppler and venogram revealed thrombosis and stenosis of the SVC. He was treated with multimodal therapy and was discharged with complete resolution of his symptoms.
A 28 year-old Caucasian female, 3.5 months postpartum, presented to the TJUH ED with facial and neck swelling. She was in her usual state of health until approximately 1 month prior to admission when she noted the gradual onset of neck swelling. The neck swelling progressed to her face 4 days prior to admission; swelling in both areas was progressive and increasingly uncomfortable. Two months prior, the patient was treated for sinusitis with a course of antibiotics by an allergist; this treatment was unsuccessful, and she was referred her to an otolaryngologist, who performed a neck ultrasound and lab work. The patient reported that several enlarged lymph nodes were found in her neck. The patient was then sent for a CT of the neck and chest, which showed a mass in her mediastinum. She was planning to follow up with a cardiothoracic surgeon, however she developed symptomatic swelling and intermittent dysphagia. The patient described a sensation of choking and strangulation; these sensations came and went at random times. She also reported tolerating only small amounts of soft foods, such as apple sauce, Jell-O, and yogurt. The dysphagia was present only with solid foods, not with liquids.The patient also complained of dull upper back pain located in her upper right trapezius area for the past month which was exacerbated by holding her child and other physical activities and was alleviated somewhat by ibuprofen; this pain felt like a pulled muscle and she rated it 4/10. She stated that chest pain, located at her right anterior chest, had bothered her for the last 4 days; she described this pain as piercing, sharp, 9/10 in severity, and intermittent, with no exacerbating or ameliorating factors.The patient's past medical history included intermittent migraines for several years which were well-controlled and a full term
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.