Document Detail

Unusual cause of superior vena cava syndrome diagnosed with transesophageal echocardiography.
MedLine Citation:
PMID:  19138918     Owner:  NLM     Status:  MEDLINE    
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.
Atilio Barbeito; Shahar Bar-Yosef; James E Lowe; Broadus Z Atkins; Jonathan B Mark
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Canadian journal of anaesthesia = Journal canadien d'anesthésie     Volume:  55     ISSN:  0832-610X     ISO Abbreviation:  Can J Anaesth     Publication Date:  2008 Nov 
Date Detail:
Created Date:  2009-01-13     Completed Date:  2009-02-09     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8701709     Medline TA:  Can J Anaesth     Country:  Canada    
Other Details:
Languages:  eng     Pagination:  774-8     Citation Subset:  IM    
Department of Anesthesiology, Box 3094, Duke University Medical Center, Durham, NC 27710, USA.
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MeSH Terms
Candidiasis / microbiology,  pathology,  surgery
Cardiopulmonary Bypass
Echocardiography, Transesophageal*
Edema / etiology,  surgery
Fungemia / complications*,  microbiology,  surgery
Heart Atria / microbiology
Kidney Failure, Chronic / complications
Middle Aged
Renal Dialysis
Superior Vena Cava Syndrome / etiology*,  surgery,  ultrasonography*
Thrombosis / complications*,  microbiology,  surgery

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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