Superior Vena Cava

vena cava superior

The superior vena cava is formed by the union of the two brachiocephalic veins behind the right first costal cartilage and descends approximately 7 cm to enter the right atrium at the level of the third costal cartilage. It collects venous blood from the head, neck, upper limbs, and thoracic wall, and receives the azygos vein from behind just before entering the pericardium.

Region: Chest

Clinical Relevance

Clinical Notes

SVC syndrome results from obstruction of the SVC by mediastinal mass, most commonly lung cancer or lymphoma, producing facial and upper extremity oedema, venous distension, and plethora. Urgent oncological treatment or SVC stenting relieves obstruction. Central venous catheters and pacemaker leads are positioned at the SVC-right atrial junction under radiological guidance. SVC perforation from central line placement is a rare but potentially fatal complication presenting with tamponade.

Pathology

Common Injuries & Conditions

SVC Syndrome

Obstruction of SVC flow by mediastinal tumour or thrombosis produces rapidly progressive facial swelling, dyspnoea, upper limb oedema, and dilated neck and chest wall veins, requiring urgent diagnosis and treatment with SVC stenting, systemic therapy, or radiotherapy.

SVC Perforation

Rare complication of central venous catheter placement, presenting with haemothorax or cardiac tamponade; prevention involves ultrasound-guided insertion and careful catheter tip positioning at the SVC-right atrial junction on post-insertion CXR.