Facial Swelling and Shortness of Breath Are Not Always an Allergic Reaction: It Could Be Acute Superior Vena Cava Syndrome

Historically, it has been found that malignancy is associated with superior vena cava (SVC) syndrome. The past decade has seen more cases of thrombogenic and stenotic SVC syndrome due to increased use of pacemakers and indwelling central lines. As compared to the slowly progressing obstruction in malignancy, rapid thrombogenesis rate and a lack of venous collateral sequelae lead to more acute sequelae in these patients. It is important to timely assess patients presented with an acute process of SVC syndrome in the emergency room. Diagnosis can quickly be made by using computed tomography angiography (CTA) or magnetic resonance angiography (MRA) modalities. The underlying cause of the syndrome is the focus of the treatment. Anticoagulation is the basis of the treatment in the case of thrombogenic catheter-associated SVC syndrome. In order to promptly manage symptoms, it was observed that balloon angioplasty with stenting and thrombolytics proved to be beneficial. Herein we are describing a 68-year-old female with past medical history of colon cancer with liver metastasis on chemotherapy via port, presented to the emergency room with acute shortness of breath and facial and neck swelling, and was found to have acute superior vena cava syndrome.