Syndrome of the inferior vena cava: symptoms and treatment
Medicine is not considered an exact science, and it is based on many assumptions and probabilities, but not facts. Syndrome of the inferior vena cava is a rather rare phenomenon in medical practice. It can manifest itself in men and women at any age, more often in the elderly. In the first place in the risk group are pregnant women. In this case, the condition of the pregnant woman is characterized by polyhydramnios, venous and arterial hypotension. Most often, the fruit is large. When the vein is squeezed, the blood flow to the liver and kidneys, the uterus, worsens, which adversely affects the development of the child. The condition can turn into a bundle of placental tissue, and this is a huge risk of developing varicose veins, thrombophlebitis on the lower limbs. If childbirth is performed by caesarean section, then the probability of collapse is high.
The concept of the inferior vena cava
The lower hollow vein is a wide vessel. It is formed by the fusion of the left and right iliac veins located in the abdominal cavity. Vienna is located at the level of the lumbar region, between 5 and 4 vertebra. Passes through the diaphragm and enters the right atrium. Vienna collects blood that passes through neighboring veins, and delivers it to the heart muscle.
If a person is healthy, then the vein works synchronously with the respiratory process, that is, expands while exhaling, and shrinks when inhaled. This is its main difference from the aorta.
The main function of the inferior vena cava is to collect venous blood from the lower extremities.
Why there are problems
According to statistics, approximately 80% of all pregnant women after 25 weeks, there is compression of the vein, to a greater or lesser extent.
If there is no syndrome of the inferior vena cava, then the pressure in the vein at a sufficiently low level is a normal physiological state. However, the problems in the tissues that surround the vein can disrupt its integrity and drastically change the blood flow. For some time the body is able to cope, finding alternative ways for blood flow. But if the pressure in the vein rises above 200 mm, then inevitably there is a crisis. In such moments without emergency medical care, everything can end in a fatal outcome. Therefore, you should know the symptoms of the syndrome of the inferior vena cava in time to call an ambulance, if the crisis begins in the patient himself or someone close.
Clinical picture
The first thing to look out for is puffiness, which can be on the face, neck, in the larynx. This symptom is observed in 2/3 of the patients. May disturb shortness of breath, cough, hoarseness of voice, even in a state of rest and lying position, and this is a huge risk of the appearance of airway obstruction.
Also, the syndrome of the inferior vena cava can be accompanied by:
- pain in the groin and abdomen;
- edema of the lower limbs;
- swelling on the buttocks and genitals;
- varicose veins in the thighs;
- impotence;
- high body temperature;
- brittle nails and hair loss;
- persistent pallor;
- problems with the legs - the patient is difficult to move even for short distances;
- fragility of bones;
- high blood pressure;
- confusion of consciousness, up to periodic loss;
- problems with hearing and vision;
- an extension of veins in the upper part of the trunk.
These symptoms also increase if the patient takes a recumbent position. Naturally, there can be no question of a calm and full-fledged dream. Often patients with this pathology fall asleep solely with hypnotic medicines.
Why can the pathology of
appear?Like most diseases, the syndrome of compression of the inferior vena cava in 80-90% of cases is associated only with disregard for one's own health, namely with smoking. The exact cause of the disease has not yet been established. But most often the syndrome arises as a concomitant symptom of lung cancer.
Other causes account for no more than 20%:
- tumors of various origin, lymphoma, sarcoma, lymphogranulomatosis, breast cancer;
- constrictive pericarditis;
- retrosternal goiter;
- silicosis;
- purulent mediastinitis;
- fibrosis.
Diagnosis
Naturally, only one symptom of the compression of the inferior vena cava is not determined. Careful diagnosis is required.
First of all, the doctor collects a full anamnesis, conducts an examination. Much can "tell" the state of veins in the neck and upper limbs, as a rule, they are enlarged. Physical examination also gives an idea: the patient has cyanosis or plethora, whether venous nets are widened in the chest area, whether there is swelling, especially in the upper parts of the body.
X-ray examination and phlebography are also prescribed. X-ray examination can be carried out with the help of contrast medium. Mandatory magnetoresonance and computer topography, possibly spiral.
In a number of cases, diagnosis of the inferior vena cava syndrome is accompanied by an in-depth examination of the ophthalmologist. The purpose of the diagnosis is to identify, if available, the retinal veins, the possible edema of the peripapillary area, to determine whether intraocular pressure has increased, whether there is stagnation in the optic nerve.
For the full picture it may be required:
- bronchoscopy;
- biopsy of sputum and focal nodes;
- sternal puncture;
- mediastinoscopy.
Therapeutic measures
The treatment of the syndrome of the inferior vena cava is symptomatic. This pathology is nevertheless a concomitant disease, and first of all it is required to cure the underlying disease that caused the appearance of the syndrome.
The main goal of the treatment is activation of the body's internal reserve forces in order to maximize the patient's quality of life. The first thing that is recommended is practically a salt-free diet and oxygen inhalations. It is possible that drugs from the group of glucocorticosteroids or diuretics will be prescribed.
If the syndrome has appeared against the backdrop of tumor development, the treatment is a completely different approach.
Surgical intervention is indicated in the following cases:
- the syndrome is rapidly progressing;
- no collateral circulation;
- occlusion of the inferior vena cava.
Surgical intervention does not eliminate problems, but only improves venous outflow.
Syndrome and pregnancy
During the period of gestation, all the organs of a woman experience a heavy load, the volume of circulating blood increases and, as a result, stagnation occurs. The uterus increases and squeezes not only the surrounding organs, but also the vessels. In the syndrome of the inferior vena cava in pregnant women, treatment should be extremely cautious.
Problems begin with the fact that it is very hard for a woman to lie on her back, usually this condition begins with the 25th week of gestation. There is a slight dizziness, weakness, periodically there is not enough air. Blood pressure, as a rule, decreases. Very rarely, but pregnant can lose consciousness.
Naturally, there are no cardinal measures of a therapeutic nature during pregnancy, but some rules will still help to transfer the syndrome easier:
- will have to give up all the exercises that are carried out in the supine position, on the back;
- to sleep also does not stand on the back;
- food should be adjusted to reduce salt intake;
- it is necessary to reduce the amount of liquid consumed;
- to improve the condition it is better to walk more, in this case muscles contract on the lower leg, and this process stimulates the advancement of venous blood upwards;
- recommended visits to the pool, water helps to squeeze blood from the veins of the lower extremities.
Prognosis and prevention of
Physicians are optimistic about patients with the syndrome if it is detected at an early stage. The only condition is constant monitoring of the health condition and patient compliance with all the recommendations of the treating doctor.
Prevention of cardiovascular diseases is a preventive measure. If there are problems with blood coagulability, the pathology should also be under constant medical control, since such patients are at risk. We should give up even the idea of self-medication.