Vena cava superior syndrome. Analisis of interventional and medical treatment options

We present a clinical case of a 72-year-old man with a history of hypertension and SARS-CoV-2 infection, urgently hospitalized in the intensive care unit due to dyspnea at rest, blushes and swelling of the neck and face, headache, and syncope. Echocardiography was performed and revealed preserved ejection fraction of left and right ventricle (EF – 57%, TAPSE – 21 mm), without hemodynamically significant valve lesions and normal ECG. On the next day of hospitalization, we performed a computer tomography (CT) scan of the lungs and it showed a tumor in right lung, compressing vena cava superior. Venography was performed and revealed subtotal thrombosis of vena cava superior and stenting with Wallstent 16/60 mm was performed. Six hours after the intervention a clinical improvement was achieved – reducing of the swelling and relieving of the symptoms.