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 occur in men and women at any age, more often in the elderly. In the first place at risk 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 a vein is squeezed, blood flow to the liver and kidneys, uterus worsens, which negatively affects the development of the child. The condition can turn into a stratification of the placental tissue, and this is a huge risk of developing varicose veins, thrombophlebitis on the lower extremities. If childbirth is performed by caesarean section, then the probability of collapse is high.
The concept of the inferior vena cava
The inferior vena cava is a wide vessel. It is formed by the fusion of the left and right iliac veins located in the abdominal cavity. The vein is located at the level of the lumbar, between the 5th and 4th vertebra. Passes through the diaphragm and enters the right atrium. A vein 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 as it exhales, and contracts when it is inhaled. This is its main difference from the aorta.
The main purpose of the inferior vena cava is the collection of venous blood of the lower extremities.
Why problems appear
According to statistics, approximately 80% of all pregnant women after 25 weeks have vein compression, to a greater or lesser extent.
If there is no lower vena cava syndrome, then the pressure in the vein is at a sufficiently low level - this is a normal physiological condition. However, problems in the tissues that surround the vein can disrupt its integrity and radically 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 a crisis invariably sets in. At such moments, without urgent medical attention, everything can be fatal. Therefore, you should know the symptoms of the inferior vena cava syndrome in order to call an ambulance in time if a crisis starts in the patient himself or in someone close.
Clinical picture
The first thing you need to pay attention to is swelling, which can be on the face, neck, in the larynx. This symptom is observed in 2/3 of patients. Shortness of breath, cough, hoarseness of the voice, even at rest and lying position, can be disturbing, and this is a huge risk of airway obstruction.
Also, the inferior vena cava syndrome can be accompanied by:
- pain in the groin and abdomen;
- swelling of the lower extremities;
- swelling on the buttocks and genitals;
- varicose veins in the thighs;
- impotence;
- high body temperature;
- brittle nails and hair loss;
- constant pallor;
- problems with legs - it’s hard for a patient to move even for short distances;
- fragility of bones;
- high blood pressure;
- confusion, up to periodic loss;
- problems with hearing and vision;
- expansion of the veins in the upper body.
These symptoms are also aggravated if the patient takes a lying position. Naturally, there can be no question of a calm and full sleep. Often patients with this pathology fall asleep exclusively with sleeping pills.
Why pathology may appear
Like most diseases, the syndrome of compression of the inferior vena cava in 80-90% of cases is associated exclusively with neglect of their own health, namely, smoking. The exact cause of the disease has not yet been established. But most often, the syndrome occurs as a concomitant symptom of lung cancer.
The remaining reasons account for no more than 20%:
- tumors of various origin, lymphoma, sarcoma, lymphogranulomatosis, breast cancer;
- constrictive pericarditis;
- sternal goiter ;
- silicosis;
- purulent mediastinitis;
- fibrosis.
Diagnostics
Naturally, only by one symptom is the syndrome of compression of the inferior vena cava not determined. A thorough diagnosis is required.
First of all, the doctor collects a complete medical history, conducts an examination. The state of the veins in the neck and upper limbs can tell a lot, as a rule, they are dilated. A physical examination also gives an idea: the patient has cyanosis or plethora, whether the venous networks in the chest area are dilated, 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 using a contrast medium. Magnetic resonance and computer topography, possibly spiral, is required.
In some cases, the diagnosis of the inferior vena cava syndrome is accompanied by an in-depth examination by an ophthalmologist. The purpose of the diagnosis is to identify, if present, retinal vein expansion, possible edema of the peripapillary region, to determine whether intraocular pressure has increased, or if there is stagnation in the optic nerve.
For the full picture you may need:
- bronchoscopy;
- biopsy of sputum and lymph nodes;
- sternal puncture;
- mediastinoscopy.
Therapeutic measures
The treatment of the inferior vena cava syndrome is symptomatic. This pathology is still a concomitant disease, and first of all, it is necessary to cure the underlying disease that caused the syndrome.
The main goal of treatment is to activate the internal reserve forces of the body in order to maximize the quality of life of the patient. The first thing that is recommended is a practically salt-free diet and oxygen inhalation. It is possible that drugs from the group of glucocorticosteroids or diuretics will be prescribed.
If the syndrome appeared against the background of the development of the tumor, a completely different approach to treatment.
Surgical intervention is indicated in the following cases:
- the syndrome is rapidly progressing;
- no collateral circulation;
- obstruction of the inferior vena cava.
Surgery does not eliminate the problems, but only improves venous outflow.
Syndrome and pregnancy
During the period of gestation, all the organs of a woman experience a severe load, the volume of circulating blood increases and, as a result, stagnation appears. The uterus grows and compresses not only the surrounding organs, but also the vessels. With the syndrome of the inferior vena cava in pregnant women, treatment should be carried out extremely carefully.
Problems begin with the fact that it is very difficult for a woman to lie on her back, usually this condition begins with 25 weeks of gestation. There is slight dizziness, weakness, periodically not enough air. Blood pressure is usually reduced. Very rarely, but a pregnant woman may lose consciousness.
Naturally, cardinal measures of a therapeutic nature during pregnancy are not discussed, but some rules will still help to transfer the syndrome more easily:
- will have to abandon all exercises that are carried out in a supine position, on the back;
- also does not stand on your back;
- nutrition should be adjusted to reduce salt intake;
- it is necessary to reduce the amount of fluid consumed;
- to improve the condition, it is better to walk more, in this case, the muscles on the lower legs contract, and this process stimulates the advancement of venous blood up;
- recommended a visit to the pool, water helps squeeze blood from the veins of the lower extremities.
Forecast and Prevention
Doctors are optimistic about patients with the syndrome if it is detected at an early stage. The only condition is constant monitoring of the state of health and patient compliance with all the recommendations of the attending physician.
As a preventive measure is the prevention of cardiovascular disease. If there are problems with blood coagulation, then the pathology should also be under constant medical supervision, since such patients are at risk. You should even abandon the thought of self-medication.