Abstract
Background A 29-year-old woman presented with chest pressure, progressive dyspnea, fatigue, and swelling of her face, neck and upper extremities. Four days earlier, she had undergone a procedure for treatment of inappropriate sinus tachycardia, during which atrioventricular node ablation and implantation of a single-lead VVI pacemaker had been performed following an unsuccessful attempt at sinus node modification.
Investigations Physical examination, contrast-enhanced CT of the chest, Doppler ultrasonography of the upper extremities, venography, coagulation studies, echocardiography.
Diagnosis Superior vena cava syndrome due to thrombotic obstruction—a complication of a cardiac procedure.
Management Anticoagulation, catheter-directed thrombolytic therapy, mechanical thrombectomy, pericardiocentesis.
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Chee, C., Bjarnason, H. & Prasad, A. Superior vena cava syndrome: an increasingly frequent complication of cardiac procedures. Nat Rev Cardiol 4, 226–230 (2007). https://doi.org/10.1038/ncpcardio0850
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DOI: https://doi.org/10.1038/ncpcardio0850
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