An under-recognized cause for superior vena cava syndrome

Abstract

A 61-year-old African American male with hypertension, endstage renal disease, on haemodialysis since four years. He was referred to cardiology for evaluation of his cardiac status prior to possible renal transplantation. During the time he was on dialysis, he initially had a left subclavian catheter for access. This was removed after an AV fistula was placed in the right arm. Due to thrombosis of the fistula, a right internal jugular tunnelled catheter was inserted and was in place for about three years. His most recent dialysis access was an AV fistula in the left forearm.Upon examination, patient's face was puffy and plethoric. His superficial neck, chest and abdominal wall veins were markedly Correspondence to: Medhat Farwati,