Physical Findings

Collateral Distention:

Once the flow in the SVC or its tributaries become compromised, a complex system of collateral veins begins to develop. These prominent veins on physical exam can be seen along the anterior chest wall( infrared), axilla and abdominal wall. There is reversal of blood flow in the veins of the upper abdominal wall

Neck Vein Distention:

Neck veins are distended and non-pulsatile in SVC syndrome as opposed to congestive heart failure where they are pulsatile.

Edema of Upper Body:

The upper body manifests signs of edema because its major flow of venous return is obstructed, as compared to the lower body which is drained by the unobstructed inferior vena cava.

Cyanosis:

Due to the local stagnation of blood flow and subsequent oxygen extraction, there is described "preferential" cyanosis. This is distributed to the face, neck and upper extremities.

Plethora

There is plethora of the upper body due to the combination of cyanosis and hyperemia of distended vessels.