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Vol 31, No 1 (2025)
Case report
Published online: 2025-03-31

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Spontaneous superior vena cava thrombosis diagnosed in a 67-year-old male patient with shortness of breath and normal serum D-dimer concentration

Grzegorz K. Jakubiak1, Aleksandra Basek2, Mikołaj Pietrzak2, Joanna Gmyrek2, Piotr Oleś2, Monika Starzak2, Agata Stanek3, Grzegorz Cieślar2
Acta Angiologica 2025;31(1):19-23.

Abstract

Introduction: Dyspnoea and fatigue are common symptoms present in a wide range of cardiovascular and pulmonary diseases. The course of diagnostics usually includes venous thromboembolism suspicion. D-dimer serum concentration measurement is sometimes thought to be disqualifying for thromboembolic event. However, it should be noted that sometimes venous thromboembolism exists despite low D-dimer concentration. Material and methods: The purpose of this paper was to present a case report of a 67-year-old male patient with superior vena cava thrombosis with slight clinical symptoms and normal D-dimer serum concentration. Results: A 67-year-old male patient was admitted to the Clinic as a matter of elective diagnostic of shortness of breath. In the course of routine diagnostics, the superior vena cava thrombosis was diagnosed. Conclusions: Venous thromboembolism (in this case superior vena cava thrombosis) may occur despite the normal level of D-dimer serum concentration. It should be noted that in the case of such a diagnosis also increased oncological invigilance is needed.

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References

  1. Mismetti P, Bertoletti L, Gouin I, et al. Elderly patients with venous thromboembolism: Insights from the RIETE registry. Presse Med. 2024; 53(4): 104246.
  2. Dzierla J, Tomczak J, Kaczewiak J, et al. The complication of deep vein thrombosis — a case report of an adolescent with catheter-related thrombosis due to treatment of congestion of caustic substance at the age of 2, treated with stent implantation after 14 years. Acta Angiol. 2024; 30(4): 155–159.
  3. Seemann K, Silas U, Bosworth Smith A, et al. The burden of venous thromboembolism in ten countries: a cost-of-illness Markov model on surgical and ICU patients. J Med Econ. 2025; 28(1): 1–12.
  4. Keller K, Sivanathan V, Farmakis IT, et al. Incidence and impact of venous thromboembolism in hospitalized patients with acute pancreatitis. Dig Liver Dis. 2024; 56(12): 2085–2094.
  5. Allikmets S, Tandanu E, Jialin KL, et al. Incidence of and risk factors for post-operative venous thromboembolism after free flap breast reconstruction in a London teaching hospital: A retrospective cohort study. J Plast Reconstr Aesthet Surg. 2024; 99: 280–288.
  6. Jakubiak G, Starzak M, Gmyrek J, et al. Large hiatal hernia as a risk factor for recurrent pulmonary embolism in a 76-year-old female patient. Acta Angiol. 2024; 30(3): 121–125.
  7. Reddy S, Kaur N, Kaur MK, et al. Pulmonary thromboembolism presenting with hoarseness of voice. BMJ Case Rep. 2024; 17(12).
  8. Saha U, Arko SB, Shama SS, et al. Pulmonary embolism: hidden in the disguise of atrial flutter/atrial tachycardia. Cureus. 2024; 16(9): e70183.
  9. Rice TW, Rodriguez RM, Light RW. The superior vena cava syndrome: clinical characteristics and evolving etiology. Medicine (Baltimore). 2006; 85(1): 37–42.
  10. Zimmerman S, Davis M. Rapid Fire: Superior Vena Cava Syndrome. Emerg Med Clin North Am. 2018; 36(3): 577–584.
  11. Otten TR, Stein PD, Patel KC, et al. Thromboembolic disease involving the superior vena cava and brachiocephalic veins. Chest. 2003; 123(3): 809–812.
  12. Li H, Wang SX, Wang W, et al. Thrombosis of the superior vena cava and auxiliary branches in patients with indwelling catheterization of the internal jugular vein. Chin Med J (Engl). 2009; 122(6): 692–696.
  13. Rivière E, Bazin C. Superior vena cava thrombosis. Am J Med. 2022; 135(9): e359–e360.
  14. Al Saadi W, Al Khalili H, Al Hajriy M. Superior vena cava syndrome-induced hemoptysis. Am J Med Sci. 2023; 365(2): 205–211.
  15. Cosmi B, Legnani C, Libra A, et al. D-Dimers in diagnosis and prevention of venous thrombosis: recent advances and their practical implications. Pol Arch Intern Med. 2023; 133(11).
  16. Lim W, Le Gal G, Bates SM, et al. American Society of Hematology 2018 guidelines for management of venous thromboembolism: diagnosis of venous thromboembolism. Blood Adv. 2018; 2(22): 3226–3256.
  17. Zawilska K, Bała M, Błędowski P, et al. Polskie wytyczne profilaktyki i leczenia żylnej choroby zakrzepowo-zatorowej – aktualizacja 2012. Medycyna Praktyczna. Kraków; wydanie specjalne: 2012.
  18. Shergill S, Bloomfield J, Fryearson J. Tipping the balance: Chronic superior vena cava thrombosis resulting in an aberrant and inefficient venous circuit. J Cardiovasc Comput Tomogr. 2022; 16(2): e20–e21.
  19. Byrne C, Abdulla J, Christensen JK. Normal D-dimer in two patients with pacemaker and deep venous thrombosis in an upper extremity. Ugeskr Laeger. 2015; 177(2A): 12–13.
  20. Talbot K, Wright M, Keeling D. Normal d-dimer levels do not exclude the diagnosis of cerebral venous sinus thrombosis. J Neurol. 2002; 249(11): 1603–1604.