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  • Case Study
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Superior vena cava syndrome: an increasingly frequent complication of cardiac procedures

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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Figure 1: Photographs of the patient showing the reduction in swelling of the face, neck and upper extremities
Figure 2: A series of venograms showing the patient's superior vena cava

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Acknowledgements

Written consent for publication was obtained from the patient.

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Correspondence to Abhiram Prasad.

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The authors declare no competing financial interests.

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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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