Vena cava compression syndrome occurs mainly in pregnant women. Changes in the uterus put pressure on the vena cava. The restricted return of blood to the heart causes circulatory problems of varying severity. Outside of pregnancy, vena cava compression syndrome is a sign of a mass in the abdomen.
What is vena cava compression syndrome?
In vena cava compression syndrome, the unobstructed return flow of blood from the legs back to the heart is obstructed. Pregnant women in particular suffer from it because the expanding uterus and the weight of the baby put pressure on the inferior vena cava. It runs on the right side of the body behind the uterus. In a supine position, the entire weight of the uterus presses on the vein, compressing it. The result is vena cava compression syndrome, which the pregnant woman experiences as a circulatory disturbance of varying severity. Although it mainly affects pregnant women, the circulatory disorder, also known as hypertensive syndrome, is just as possible in non-pregnant women and men. Vena cava compression syndrome is then an indication that there may be abnormal tissue enlargement in the abdomen that builds up pressure similar to vena cava compression syndrome in a pregnant woman.
Causes
Vena cava compression syndrome is a circulatory disorder caused by mechanical pressure. It originates from the inferior vena cava. This is the inferior vena cava, a large blood vessel that receives blood flow from the lower extremities. It runs in the right side of the body behind the uterus, which otherwise has no influence on the inferior vena cava in the normal state when the patient is in a supine position. It is only when the uterus enlarges and gains weight during pregnancy that vena cava compression syndrome occurs in some pregnant women in this supine position. The weight is then sufficient to compress the artery. Blood flow to the heart is reduced. Blood for onward transport to the lungs and other parts of the body is no longer available in sufficient quantity in vena cava compression syndrome.
Symptoms, complaints, and signs
Vena cava compression syndrome is characterized by sudden drop in blood pressure, profuse sweating, dizziness, cold sweat, nausea, pallor, and impaired consciousness, among other symptoms. The disturbances of consciousness can lead to unconsciousness. Furthermore, edema of the legs is frequently observed. In some cases, palpitations occur. Later, a slowed heartbeat is often also possible. In addition, some patients suffer from shortness of breath. However, not all symptoms always manifest themselves. Since blood circulation is deficient, the unborn child may also be affected. The fetus is then no longer supplied with sufficient oxygen. In extreme cases, this can lead to the child dying in the womb as a result of circulatory shock to the mother. However, life-threatening complications are very rare for both the mother and the child in lower vena cava compression syndrome. When the upper cervical veins are affected by vena cava compression syndrome, congestion occurs primarily in the cervical veins. Sometimes, however, the veins also protrude additionally on the arms and head. Those affected then often suffer from headaches. If the swelling or tumor presses on other organs, other symptoms may occur. If the pressure is on the trachea, breathing problems are the main concern. If the esophagus is affected, the main symptom is difficulty swallowing. Without treatment, the symptoms of superior vena cava compression syndrome often worsen.
Diagnosis and course
Vena cava compression syndrome is usually self-recognizable to a pregnant woman. The particular association with lying on the back is very typical. The clarification by the treating gynecologist is mostly done by a detailed inquiry of the situation in which the symptoms of the vena cava compression syndrome occur. The diagnosis in other groups of persons is more extensive, since here the triggering space lesions must be determined more precisely. This necessarily requires the use of imaging techniques. Vena cava compression syndrome requires a response from the affected person by a rapid change of position. The body reacts only initially with dizziness and shortness of breath. If the interruption of blood flow is not corrected, the circulatory disturbances intensify.Consequences of vena cava compression syndrome eventually include unconsciousness to cardiac arrest and endangerment of the unborn child due to oxygen deficiency.
Complications
In the worst case, vena cava compression syndrome can lead to the death of the patient. This case usually occurs only if the condition is not treated. Sufferers of this syndrome suffer from severe dizziness and nausea. Circulatory problems and fainting can also occur and have a very negative impact on the quality of life of the affected person. Many patients injure themselves during a loss of consciousness due to a fall. Furthermore, vena cava compression syndrome leads to palpitations, and the affected person may also suffer a heart attack. Respiratory distress and a significantly reduced ability to cope with stress also occur in this case and significantly restrict the patient’s everyday life. If vena cava compression syndrome occurs in childhood, the child’s development is significantly restricted. As a result, those affected often suffer from severe limitations and complications in adulthood as well. As a rule, the symptoms of vena cava compression syndrome can be cured. Complications do not occur. Only in some cases surgical interventions are necessary. In most cases, if the syndrome is diagnosed and treated early, the patient’s life expectancy is not negatively affected.
When should you see a doctor?
In vena cava compression syndrome, the affected person should usually always see a doctor. There can be no self-healing in this condition, so treatment must always be given. However, early diagnosis always has a very positive effect on the further course of the disease. A doctor should be contacted if the affected person suffers from heavy sweating and further also from dizziness. In some cases, this can even lead to a complete loss of consciousness, in which case an emergency doctor should be called. Furthermore, severe shortness of breath or palpitations may also indicate the syndrome. Those affected often suffer from headaches or even swelling of the head. Furthermore, swallowing difficulties may also indicate vena cava compression syndrome if they occur over a long period of time and do not disappear on their own. A general practitioner can be consulted for this condition. Further treatment is then usually given in a hospital.
Treatment and therapy
Vena cava compression syndrome can usually be prevented or corrected in pregnant women without extensive medical treatment. After the 12th week of pregnancy, the uterus is heavy enough to cause hypertensive syndrome. Therefore, it is recommended to take an upright position immediately when the symptoms appear. The circulatory disturbances usually subside very quickly. The lateral position is much more advantageous and relieves the inferior vena cava. Blood flow to the heart can proceed undisturbed. Treatment of vena cava compression syndrome in non-pregnant patients first requires that the cause of the circulatory disturbances be clarified. In most cases, this involves tumors in the abdominal cavity. Surgical removal is used to relieve the pressure on the artery. In some cases, a modified lying position of the patient is required until removal. He or she must rest in a slightly upright or at least lateral position to prevent vena cava compression syndrome from occurring.
Prevention
Prevention in vena cava compression syndrome essentially concerns pregnant women. As early as possible, these refrain from a flat supine position to avoid the circulatory problems. The lateral position is more advantageous but cannot be maintained permanently. To avoid the symptoms of vena cava compression syndrome even in the supine position, pregnant women can place a flat pillow under the right side of their body. This causes a slight tilt to the left, which slightly displaces the uterus and prevents vena cava compression syndrome.
Follow-up
Because vena cava compression syndrome occurs exclusively during pregnancy, it is a condition or complication that requires follow-up care as the pregnancy continues. After delivery of the baby, there are no further consequences or complications for the mother that would be expected as a result of vena cava compression syndrome.The vena cava compression syndrome is not to be regarded as a disease in its own right, but a phenomenon that occurs very frequently due to pregnancy and does not normally require any follow-up treatment in a healthy patient. Follow-up care in this case is primarily directed at the patient in educating her about the cause of the occurrence of vena cava compression syndrome. By avoiding appropriate body positions – such as lying supine for prolonged periods – blood flow to the heart can be ensured and the symptoms will not recur. Further special follow-up is usually not required, and drug therapy is not necessary. However, immediately after the onset of vena cava syndrome, attention should be paid to repositioning the patient and stabilizing the circulation. Other symptoms that occur generally resolve on their own very quickly after repositioning and leave no harm to the mother or child.
What you can do yourself
If signs of vena cava compression syndrome occur, the gynecologist must be consulted. Vena cava compression requires medical evaluation and treatment. Affected women can remedy the condition themselves by appropriate positioning. The necessary measures should be supervised by a physician. In severe cases, surgical intervention is necessary. Women who repeatedly suffer from the dangerous compression should visit a hospital. As a rule, the gynecologist in charge will initiate the further steps. After the surgical intervention, during which the vena cava is relieved, the patient must take care of herself. This is usually accompanied by initial preparations for childbirth in order to be prepared in the event of a recurrence of vena cava compression syndrome. Affected women also need support in everyday life because of the pregnancy. In the absence of a partner, an ambulatory care service is a good option. In addition, observation of physical symptoms is necessary. Pressure in the uterine area, severe pain or dizziness indicate a complication. The emergency medical service or the ambulance service are suitable contacts. If symptoms recur, temporary hospitalization is recommended until the baby is born.
