Superior vena cava thrombosis complicated by soft tissue edema of the neck in a patient with chronic obstructive pulmonary disease (a clinical case)

Abstract

Introduction. Superior vena cava thrombosis (SVCT) is a severe pathological condition characterized by impaired venous outflow from the head, neck, and upper extremities and may lead to the development of superior vena cava syndrome. Chronic obstructive pulmonary disease (COPD) is one of the leading chronic respiratory diseases, often complicated by hemodynamic disturbances and an increased risk of thrombosis. The combination of these conditions represents a significant clinical challenge due to their mutually aggravating course. Objective. To familiarize practicing physicians with the features of diagnosis and treatment of superior vena cava thrombosis complicated by soft tissue edema of the neck in a patient with COPD. Materials and Methods. A clinical case of a patient with COPD who developed superior vena cava thrombosis with soft tissue edema of the neck is presented. An analysis of medical history data, clinical examination findings, and results of laboratory and instrumental studies was performed, including chest radiography, computed tomography, ultrasound examination of the neck vessels, and coagulation testing. The effectiveness of the administered therapy was assessed. Results. Clinical observation revealed that a patient with long-standing COPD developed superior vena cava thrombosis, presenting with neck swelling, facial cyanosis, dyspnea, and a sensation of fullness in the head. Chronic hypoxia, systemic inflammation, and associated risk factors were found to contribute to thrombogenesis. Soft tissue edema of the neck significantly complicated the clinical course and worsened the patient’s quality of life. Anticoagulant therapy and optimization of COPD treatment led to a gradual reduction in symptoms and improvement of the patient’s condition. Conclusions. Superior vena cava thrombosis in patients with COPD has a mutually aggravating nature and may significantly complicate the course of the underlying disease. In the presence of neck edema, facial cyanosis, and progressive dyspnea in COPD patients, superior vena cava thrombosis should be considered and excluded. Timely diagnosis and appropriate anticoagulant therapy can reduce the risk of complications and improve prognosis.