231 Superior vena caval obstruction
Salient features
History
Examination
• Tortuous, visible and dilated veins on the chest wall and neck (Fig. 231.1).
• The neck veins are non-pulsatile
• The face may be plethoric and suffused. The patient may be short of breath
• Look for signs of Horner syndrome and for radiation marks
• Tell the examiner that you would like to examine for signs of bronchogenic carcinoma, i.e. clubbing, tar staining, lymph nodes and chest signs.
