Advanced Oncology Certified Nurse Practitioner (AOCNP) Certification Practice Test

Initial symptoms of superior vena cava (SVC) syndrome typically include?

1. Chest pain and fever

2. Unexplained weight loss

3. Nonproductive cough and hoarseness

4. Shortness of breath at rest

The correct answer is: Nonproductive cough and hoarseness

The initial symptoms of superior vena cava (SVC) syndrome often manifest as a combination of nonproductive cough and hoarseness due to the compression of structures in the mediastinum by a mass or swelling affecting the SVC. As the superior vena cava is responsible for returning blood from the head, neck, and upper extremities to the heart, any obstruction can lead to venous congestion and resultant symptoms. The nonproductive cough can occur as a result of airway irritation or compression, while hoarseness can develop if the recurrent laryngeal nerve is affected or due to compression of the surrounding structures. These symptoms are typically early indicators of SVC syndrome and warrant further investigation, often revealing an underlying malignancy or other causes of venous obstruction. Chest pain and fever, unexplained weight loss, and shortness of breath at rest are more common in other clinical conditions or later stages of SVC syndrome, but are not typically among the very first symptoms noticed. The presence of nonproductive cough and hoarseness provides a clearer understanding of the early vascular and respiratory changes that occur with SVC syndrome.