Medicine is not considered an exact science, and it is based on many assumptions and probabilities, but not facts. Inferior vena cava syndrome is a rather rare occurrence in medical practice. It can occur in men and women at any age, more often in the elderly. Pregnant women are in the first place at risk. In this case, the condition of the pregnant woman is characterized by polyhydramnios, venous and arterial hypotension. Most often, the fetus is large. When the vein is compressed, the blood flow to the liver and kidneys, the uterus worsens, which negatively affects the development of the child. The condition can result in a stratification of the placental tissue, and this is a huge risk of developing varicose veins, thrombophlebitis in the lower extremities. If the birth is carried out by caesarean section, then there is a high probability of collapse.
The concept of 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 vertebrae. It passes through the diaphragm and enters the right atrium. The vein collects blood that passes through neighboring veins and delivers it to the heart muscle.
If a person is he althy, then the vein works synchronously with the respiratory process, thenIt expands on exhalation and contracts on inhalation. This is its main difference from the aorta.
The main purpose 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 experience vein compression after 25 weeks, to a greater or lesser extent.
If there is no inferior vena cava syndrome, then the pressure in the vein at a sufficiently low level is a normal physiological condition. However, problems in the tissues that surround the vein can compromise its integrity and drastically change blood flow. For a while, the body is able to cope by finding alternative ways for blood to flow. But if the pressure in the vein rises above 200 mm, then a crisis invariably sets in. At such moments, without urgent medical care, everything can end in death. Therefore, you should know the symptoms of the inferior vena cava syndrome in order to call an ambulance in time if a crisis begins 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. May experience shortness of breath, cough, hoarseness, even at rest and lying down, and this is a huge risk of airway obstruction.
Also, inferior vena cava syndrome may be accompanied by:
- pain in the groin areaand belly;
- swelling of the lower extremities;
- swelling on the buttocks and genitals;
- varicose veins of small vessels in the thigh area;
- impotence;
- high body temperature;
- brittle nails and hair loss;
- constant pallor;
- problems with legs - it is difficult for the patient to move even for short distances;
- brittle bones;
- high blood pressure;
- confusion, up to periodic loss;
- hearing and vision problems;
- varicose veins in the upper body.
These symptoms are also aggravated if the patient takes the supine position. Naturally, a calm and full sleep is out of the question. Often, patients with this pathology fall asleep exclusively with sleeping pills.
Why pathology may appear
Like most diseases, compression syndrome of the inferior vena cava in 80-90% of cases is associated solely with neglect of one's own he alth, 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.
Other causes account for no more than 20%:
- tumors of various origins, lymphoma, sarcoma Hodgkin's disease, breast cancer;
- constrictive pericarditis;
- retrosternal goiter;
- silicosis;
- purulent mediastinitis;
- fibrosis.
Diagnosis
It is natural that the syndrome of compression of the inferior vena cava is not determined by only one symptom. Thorough diagnosis required.
First of all, the doctor collects a complete history, conducts an examination. A lot can "tell" the state of the veins in the neck and upper limbs, as a rule, they are dilated. Physical examination also gives an idea: the patient has cyanosis or plethora, whether the venous networks in the chest area are expanded, 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 a contrast agent. Be sure to carry out magnetic resonance and computer topography, possibly spiral.
In some cases, the diagnosis of 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 dilatation, possible swelling of the peripapillary region, to determine whether intraocular pressure has increased, whether 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 interventions
Treatment of inferior vena cava syndrome is symptomatic. This pathology is still a concomitant disease, and first of all it is required to curethe underlying disease that caused the syndrome.
The main goal of treatment is to activate the body's internal reserve forces in order to maximize the patient's quality of life. The first thing that is recommended is a practically s alt-free diet and oxygen inhalations. 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 a tumor, a completely different approach to treatment.
Surgery is indicated in the following cases:
- the syndrome is rapidly progressing;
- no collateral circulation;
- blockage 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 organs of a woman experience the heaviest load, the volume of circulating blood increases and, as a result, stagnation appears. The uterus increases and compresses not only the surrounding organs, but also the vessels. Inferior vena cava syndrome in pregnant women should be treated with extreme caution.
Problems begin with the fact that it is very difficult for a woman to lie on her back, usually this condition begins from the 25th week of gestation. There is a slight dizziness, weakness, periodically there is not enough air. Blood pressure usually decreases. Very rarely, a pregnant woman may lose consciousness.
Of course, about cardinal measures of a therapeutic nature during the periodpregnancy is out of the question, but some rules will still make it easier to endure the syndrome:
- you will have to abandon all exercises that are carried out in a supine position, on your back;
- also do not sleep on your back;
- diet should be adjusted to reduce s alt 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 leg contract, and this process stimulates the movement of venous blood up;
- recommended to visit the pool, water helps to squeeze out 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 he alth and compliance by the patient with all the recommendations of the attending physician.
Prevention of cardiovascular diseases acts as a preventive measure. If there are problems with blood clotting, then the pathology should also be under constant medical supervision, since such patients are at risk. Even the thought of self-treatment should be abandoned.
