Inferior vena cava syndrome

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Inferior vena cava syndrome
Classification and external resources
ICD-10	I 87.1
eMedicine	emerg/2718

Inferior vena cava syndrome (IVCS) is a result of obstruction of the inferior vena cava. It can be caused by invasion or compression by a pathological process or by thrombosis in the vein itself.

[edit] Frequency

Epidemiological data is elusive owing to the wide variety of clinical presentation. In the U.S., incidence is estimated to be at 5–10 cases per 100'000 per year.

[edit] Causes

Obstruction by deep vein thrombosis or tumors (most commonly renal cell carcinoma)
Compression through external pressure by neighbouring structures or tumors, either by significantly compressing the vein or by promoting thrombosis by causing turbulence by disturbing the blood flow. This is quite common during the third trimester of pregnancy when the uterus compresses the vein in the right side position.
Iatrogenic causes may be suspected in patients with a medical history of liver transplantion, vascular catheters, dialysis and other invasive procedures in the vicinity
Budd-Chiari syndrome

[edit] Symptoms

IVCS presents with a wide variety of signs and symptoms, making it difficult to diagnose clinically.

Edema of the lower extremities
Tachycardia
In pregnant women, signs of fetal hypoxia and distress may be seen in the cardiotocography

Cardiovascular disease: vascular disease · Circulatory system pathology (I70–I99, 440–456)

Arteries, arterioles
and capillaries

Inflammation

Arteritis (Aortitis) · Buerger's disease

Arterial occlusive disease/
peripheral vascular disease

Arteriosclerosis	Atherosclerosis (Foam cell, Fatty streak, Atheroma, Intermittent claudication) · Monckeberg's arteriosclerosis · Arteriolosclerosis (Hyaline, Hyperplastic, oxycholesterol, cholesterol, LDL, trans fat)

Stenosis	Renal artery stenosis · Carotid artery stenosis

Other	Fibromuscular dysplasia · Degos disease · Aortoiliac occlusive disease · Raynaud's phenomenon/Raynaud's disease · Erythromelalgia

Aneurysm/dissection/
pseudoaneurysm

torso: Aortic aneurysm (Thoracic aortic aneurysm, Abdominal aortic aneurysm) · Aortic dissection · Coronary artery aneurysm

head/neck: Cerebral aneurysm · Intracranial berry aneurysm · Carotid artery dissection · Vertebral artery dissection · Familial aortic dissection

Vascular malformation

Arteriovenous malformation · Arteriovenous fistula · Telangiectasia (Hereditary hemorrhagic telangiectasia)

Vascular nevus

Spider angioma · Halo nevus · Cherry hemangioma

Veins

Inflammation	Phlebitis

Venous thrombosis/ Thrombophlebitis	primarily lower limb (Deep vein thrombosis) abdomen (Hepatic veno-occlusive disease, Budd–Chiari syndrome, May-Thurner syndrome, Portal vein thrombosis, Renal vein thrombosis) upper limb/torso (Paget-Schroetter disease, Mondor's disease) head (Cerebral venous sinus thrombosis) Post-thrombotic syndrome

Varicose veins	Varicocele · Gastric varices · Portacaval anastomosis (Hemorrhoid, Esophageal varices, Caput medusae)

Other	Superior vena cava syndrome · Inferior vena cava syndrome · Venous ulcer · Chronic venous insufficiency · Chronic cerebrospinal venous insufficiency

Arteries or veins

Vasculitis · Thrombosis · Embolism (Pulmonary embolism, Cholesterol embolism, Paradoxical embolism) · Angiopathy (Macroangiopathy, Microangiopathy)

Blood pressure

Hypertension	Hypertensive heart disease · Hypertensive nephropathy · Essential hypertension · Secondary hypertension (Renovascular hypertension) · Pulmonary hypertension · Malignant hypertension · Benign hypertension · Systolic hypertension · White coat hypertension

Hypotension	Orthostatic hypotension