Superior Vena Caval System Obstruction

McCord, Malcolm C.; Edlin, Philip; Block, Malcolm

doi:10.1378/chest.19.1.19

Cited by 14 publications

(3 citation statements)

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“…McCord, Edlin, and Block described a patient who died 50 years after the development of evidence of collateral circulation after a febrile illness in childhood, the superior vena cava having been completely obstructed by a fibrocalcific mass. 3 Glushien and Mansuy have described a patient living and working 36 years after a rather sudden onset of superior vena cava obstruction.4 In that case, although the superficial dilated tortuous veins continued down over the abdomen, the azygos vein was considered not to be occluded because the venous pressure in the arms did not rise when a constricting band was applied to the chest wall and because the venous pressure fluctuated normally with respiration. The authors concluded that, despite the functioning of the azygos vein as a superior vena cava, some blood from the upper part of the body was being returned via the inferior vena cava.…”

Section: Commentmentioning

confidence: 99%

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Obstruction of the Superior Vena Cava of Twenty-Five Years' Duration

Rose¹

1952

JAMA

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be beneficial while preparations are being made for splenectomy.Five platelet transfusions given to three subjects with aplastic anemia showed survival times of four to six days. A representative result is charted in figure 6. The effect of the transfused platelets in increasing clot retraction is illustrated in figure 7. Hirsch and Gardner have reported a similar experience.16b These results are good enough to be of practical value in helping to support a patient during periods of temporary depression of platelet formation. They are limited, however, by the fact that platelet antibodies seem to develop, so that with repeated transfusions the platelet survival becomes progressively shorter.16b If platelet types could be determined in a practical manner, so that platelets of the same sérologie type could be given, the therapeutic value of these transfusions might be greatly increased. CONCLUSIONS 1. The plasma of some patients with idiopathic thrombocytopenic purpura contains a thrombocytopenic factor that lowers the level of circulating platelets and damages megakaryocytes. 2. The spleen probably plays at least a dual role in this disease, particularly in the removal of sensitized platelets and sharing in antibody production. 3. Specific platelet groups probably exist; isoimmunization by incompatible platelet transfusions seems to occur. 4. Platelet transfusions are of limited therapeutic importance but may be of value in idiopathic thrombocytopenic purpura immediately prior to splenectomy and in acute aplastic anemias until the bone marrow recovers. Their effectiveness is limited by the fact that platelet survival tends to decrease progressively when repeated transfusions are given. 600 S. Kingshighway Blvd. (Dr. Sprague).Intrinsic Asthma.-We have gotten away from the old idea that the paranasál sinuses were important foci of infection in relation to asthma. While at times this may be true, the sinusitis, especially the hyperplastic form, more often is a result of the allergic processes rather than its cause. Radical operations should not be done unless there exists extensive suppuration which cannot be improved by other methods, especially modern biotherapy. We seldom have had to resort to such procedures in our patients and, as 1 have reported elsewhere, the assumption that asthma is of infectious or intrinsic origin often is based upon the inability to find the specific cause; it then becomes a simple matter to conclude that the patient has a bacterial allergy and to treat him accordingly. While the asthma may be due to bacterial allergy, such a conclusion should not be reached until every effort has been made to find a nonbacterial factor or, if not, to treat the patient as though it were nonbacterial. Wherever necessary, of course, vaccines, whether stock or autogenous (especially those obtained by bronchoscopic aspiration), may be useful adjuncts provided they are used with caution and in small doses. In the past three or four years, we have been employing the intracutaneous method of administration for va...

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Section: Commentmentioning

confidence: 99%

“…The spleen probably plays at least a dual role in this disease, particularly in the removal of sensitized platelets and sharing in antibody production. 3. Specific platelet groups probably exist; isoimmunization by incompatible platelet transfusions seems to occur.…”

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confidence: 99%

Obstruction of the Superior Vena Cava of Twenty-Five Years' Duration

Rose¹

1952

JAMA

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“…The patient was discharged from the hospital on April 3,1950 and followed as an outpatient, at which time he showed marked general improvement and his hoarseness totally disappeared. This patient was readmitted to the Pennsylvania Hospital on June 20, 1950, on the service of Dr. Leonard W. Parkhurst, because of progressive dyspnea and beginning edema of the lower extremities.…”

Section: Report Of Casesmentioning

confidence: 99%

LXVIII Superior Vena Caval Obstructive Syndrome

Lell

1951

Ann Otol Rhinol Laryngol

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Superior Vena Cava Syndrome

Calenda¹

1953

AMA Arch Intern Med

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RECENTLY we observed a case of superior vena cava syndrome which resulted from a dissecting aneurysm of the thoracic aorta. This unusual combination of vascular lesions prompted us to review the autopsy files of the Rhode Island Hospital. In the period 1932-1951, a total of 7,006 autopsies were performed. Dissecting aneurysm of the aorta was encountered in 25 cases, an incidence of 0.35%. In none of these was there superior vena cava obstruction. A review of the literature disclosed that in only one other instance has such an entity been described.1 We wish to report the second such case, which clearly demonstrated simple obstruction of the superior vena cava. In addition, we wish to present one of two cases of aorticocaval communication treated at the Rhode Island Hospital and to differentiate between this condition and simple obstruction of the superior vena cava. REPORT OF CASESCase 1.\p=m-\E. M., a 41-year-old white man, was admitted to the Rhode Island Hospital on Nov. 6, 1952, because of extreme cyanosis involving the head, arms, and upper part of the chest. Two days prior to admission, while walking down a flight of stairs at his home, he experienced sudden severe substernal pain radiating down the middle of the body to the level of the umbilicus. This episode was followed by syncope. The patient was carried back upstairs and shortly after¬ wards was admitted to the psychiatric ward of the Charles V. Chapin Hospital, because it was thought that he was suffering from alcoholism. At that institution a presumptive diagnosis of superior vena cava obstruction was made, and the patient was transferred to the Rhode Island Hospital for further care.Past History.-The patient was studied at the Lahey Clinic in 1946 because of a neurological disorder. It was thought at that time that he probably had widespread disseminated sclerosis.Physical Examination.-The temperature was 100.8 F., pulse rate 120, respiration 28, blood pressure 125/96 (left arm) and 130/90 (right arm). The'patient was a well-developed wellnourished man lying quietly in bed in moderate respiratory distress. The skin was a striking reddish-blue in both upper extremities and the neck, chest, head, and face. The veins of the neck and arms were obviously engorged. The skin was edematous in the upper portions of the body. No rash or ulcers were noted. The lips were cyanotic. The conjunctivae were slightly injected. The pupils were round, regular, and equal and reacted to light and accommodation. The fundi revealed normal discs with no hemorrhages or exudates. The tongue was dry and well papillated. The carotid pulsations in the neck were easily palpable. The lungs were clear to auscultation and percussion. No widening of the mediastinum could be demonstrated by percussion. The heart was normal in size, with normal sinus rhythm. No murmur or thrill could be detected on careful examination of the right anterior chest, sternum, and precordium.

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Superior Vena Caval System Obstruction

Cited by 14 publications

References 5 publications

Obstruction of the Superior Vena Cava of Twenty-Five Years' Duration

Obstruction of the Superior Vena Cava of Twenty-Five Years' Duration

LXVIII Superior Vena Caval Obstructive Syndrome

Superior Vena Cava Syndrome

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