Upper congestion of influence
| Classification according to ICD-10 | |
|---|---|
| I50.xx | Heart failure with right heart involvement |
| I87.1 | Superior vena cava syndrome |
| ICD-10 online (WHO version 2019) | |
In medicine, upper congestion (OES) is a symptom in which the venous return to the heart from the upper extremities and the head is obstructed. It manifests itself in the form of congested swollen neck veins (symptom of Stokes' collar ) and arm veins.
clinic
The OES is diagnosed in the 45 ° upper body elevated patient. The external jugular vein can be seen two transverse fingers above the collarbone (positive result).
The upper accumulation of influence itself usually does not cause any problems. Head pressure, a feeling of full blood in the head and headache may also occur. Often there is shortness of breath or a deterioration in the general condition as an expression of the underlying disease. The symptoms are aggravated when lying down, as gravity no longer supports the venous blood flow back to the heart.
Depending on the cause, there is a risk of venous thrombosis .
causes
Upper congestion of influence is usually a sign of poor performance of the right heart . Possible causes are:
- Heart valve defect with leaks in the valve
- Left heart failure
- Pericardial tamponade
- Tension pneumothorax
- bronchial asthma
- Pulmonary embolism
Tumors of the mediastinum that press on the large superior vena cava (for example, advanced bronchial carcinoma can cause compression of the superior vena cava) are less common . If the upper congestion of the influence has persisted for a long time, venous bypassing circuits can develop ( superior vena cava syndrome ). The causative tumors can be: bronchial carcinoma , malignant lymphoma , acute lymphocytic leukemia (T-ALL), thyroid carcinoma , teratoma , lymph nodes - metastases of a tumor in the mediastinum, very rarely benign processes such as B. extensive goiter (goiter).
Individual evidence
- ^ Klaus Holldack, Klaus Gahl: Auscultation and percussion. Inspection and palpation. Thieme, Stuttgart 1955; 10th, revised edition, ibid 1986, ISBN 3-13-352410-0 , p. 46.
- ^ Roman Fischbach: Interventional regional tumor therapy. In: Eberhard Aulbert, Friedemann Nauck, Lukas Radbruch (eds.): Textbook of palliative medicine. 3rd, updated edition. Schattauer, Stuttgart 2012, ISBN 978-3-7945-2666-6 , pp. 664-680, here: pp. 671 f.
