Unusual cause of superior vena cava syndrome diagnosed with transesophageal echocardiography.

Journal Article

PURPOSE: An unusual case of superior vena cava (SVC) syndrome caused by an infected right atrial-SVC junction thrombus may be diagnosed using transesophageal echocardiography. CLINICAL FEATURES: A 59-yr-old male with end-stage renal disease requiring hemodialysis presented with fungemia and later developed facial and bilateral upper extremity edema. Transesophageal echocardiography revealed subtotal occlusion of the SVC at its junction with the right atrium. The mass was surgically removed with cardiopulmonary bypass support. Pathological examination of the mass confirmed the presence of a large fungal colony of Candida species mixed in the thrombus. The patient's signs and symptoms of SVC obstruction resolved, and he was discharged from the hospital four weeks later in stable condition. CONCLUSION: Although usually caused by extrinsic tumour compression, SVC syndrome can result from intravascular caval obstruction. This etiology should also be considered in the differential diagnosis, particularly in patients with intravascular devices. Transesophageal echocardiography is a valuable diagnostic tool in these cases.

Full Text

Duke Authors

Cited Authors

  • Barbeito, A; Bar-Yosef, S; Lowe, JE; Atkins, BZ; Mark, JB

Published Date

  • November 2008

Published In

Volume / Issue

  • 55 / 11

Start / End Page

  • 774 - 778

PubMed ID

  • 19138918

International Standard Serial Number (ISSN)

  • 0832-610X

Digital Object Identifier (DOI)

  • 10.1007/BF03016351

Language

  • eng

Conference Location

  • United States