Superior vena cava syndrome physical examination

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Maria Fernanda Villarreal, M.D. [2]

Overview

Common physical examination findings of superior vena cava syndrome include the pemberton's sign, facial swelling, and jugular venous distension.

Physical Examination

Appearance of the Patient

• Well-appearing in early stages of the cancer
• Cachectic in late stages of the cancer
• Pemberton's sign: development of suffusion, plethora, or duskiness upon elevation of the arms above the head in patients with SVC syndrome.

Vital Signs

• Low-grade fever
• Tachypnea
• Kussmal respirations may be present in advanced SVCS.
• Asymmetric pulse

Skin

• Reddish mucus membranes (inside the nose, mouth, and other places)
• Redish color to the skin

HEENT

• Facial tenderness
• Swelling of the face
• Facial flushing/redness face or cheeks
• Drooping eyelid
• Swelling around the eye
• Swelling of the whites of the eyes

• 

  Swelling of the face

Neck

• Jugular venous distension
• Lymphadenopathy
• Thyromegaly
• Hepatojugular reflux

• 

  Marked jugular venous distention with the external jugular vein marked by an arrow.

Lungs

• Asymmetric chest expansion
• Wheezing may be present

Extremities

• Edema of the upper extremities