You are caring for a patient with an advanced stage of breast cancer. The cancer has metastasized. You enter the room and find the patient struggling to breath. You note that this patient's jugular veins are distended
What would you suspect is happening with this patient?
A) Increased intracranial pressure
B) Superior vena cava syndrome (SVCS)
C) Spinal cord compression
D) Metastatic tumor of the neck
Ans: B
Feedback: Superior vena cava syndrome (SVCS) occurs when there is gradual or sudden impaired venous drainage giving rise to progressive shortness of breath (dyspnea), cough, hoarseness, chest pain, and facial swelling; edema of the neck, arms, hands, and thorax and reported sensation of skin tightness and difficulty swallowing; as well as possibly engorged and distended jugular, temporal, and arm veins. Option A is incorrect; increased intracranial pressure may be a part of SVCS, but it is not what is causing the patient's symptoms. Option C is incorrect; the scenario does not mention a problem with the patient's spinal cord. Option D is incorrect; the scenario says that the cancer has metastasized but not that it has metastasized to the neck.
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