Aortocaval compression syndrome

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Aortocaval compression syndrome
Other namesSupine hypotensive syndrome
Supine hypotensive syndrome 2.jpg
A watercolor drawing of a pregnant woman lying flat on her back, causing the aorta and inferior vena cava to compress and reduce circulation.
Specialty Obstetrics and gynaecology

Aortocaval compression syndrome also known as Supine hypotensive syndrome is compression of the abdominal aorta and inferior vena cava by the gravid uterus when a pregnant woman lies on her back, i.e. in the supine position. It is a frequent cause of low maternal blood pressure (hypotension), which can result in loss of consciousness [1] and in extreme circumstances fetal demise. [2] [3]

Contents

Signs and symptoms

Aortocaval compression syndrome may cause syncope, restlessness, dizziness, headache, tinnitus, visual disturbances, numbness or paresthesia of the limbs, abdominal/chest discomfort or pain, nausea, and vomiting. [4] Some patients may be asymptomatic. [5]

See also

Related Research Articles

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The superior vena cava (SVC) is the superior of the two venae cavae, the great venous trunks that return deoxygenated blood from the systemic circulation to the right atrium of the heart. It is a large-diameter (24 mm) short length vein that receives venous return from the upper half of the body, above the diaphragm. Venous return from the lower half, below the diaphragm, flows through the inferior vena cava. The SVC is located in the anterior right superior mediastinum. It is the typical site of central venous access via a central venous catheter or a peripherally inserted central catheter. Mentions of "the cava" without further specification usually refer to the SVC.

<span class="mw-page-title-main">Inferior vena cava</span> One of two veinous trunks bringing deoxygenated blood back to the heart

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<span class="mw-page-title-main">Hypotension</span> Abnormally low blood pressure

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<span class="mw-page-title-main">Inferior vena cava filter</span>

An inferior vena cava filter is a medical device made of metal that is implanted by vascular surgeons or interventional radiologists into the inferior vena cava to prevent a life-threatening pulmonary embolism (PE) or venous thromboembolism (VTE).

<span class="mw-page-title-main">Inferior vena cava syndrome</span> Medical condition

Inferior vena cava syndrome (IVCS) is a very rare constellation of symptoms resulting from either an obstruction, or stenosis of the inferior vena cava. It can be caused by physical invasion or compression by a pathological process or by thrombosis within the vein itself. It can also occur during pregnancy. Pregnancy leads to high venous pressure in the lower limbs, decreased blood return to the heart, decreased cardiac output due to obstruction of the inferior vena cava, sudden rise in venous pressure which can lead to placental separation, and a decrease in kidney function. All of these issues can arise from lying in the supine position during late pregnancy which can cause compression of the inferior vena cava by the uterus. Symptoms of late pregnancy inferior vena cava syndrome consist of intense pain in the right hand side, muscle twitching, hypotension, and fluid retention.

<span class="mw-page-title-main">May–Thurner syndrome</span> Medical condition

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<span class="mw-page-title-main">Nutcracker syndrome</span> Medical condition

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<span class="mw-page-title-main">Aortic rupture</span> Rupture or breakage of the aorta, the largest artery in the body

Aortic rupture is the rupture or breakage of the aorta, the largest artery in the body. Aortic rupture is a rare, extremely dangerous condition. The most common cause is an abdominal aortic aneurysm that has ruptured spontaneously. Aortic rupture is distinct from aortic dissection, which is a tear through the inner wall of the aorta that can block the flow of blood through the aorta to the heart or abdominal organs.

<span class="mw-page-title-main">Ovarian vein syndrome</span> Medical condition

Ovarian vein syndrome is a rare condition in which a dilated ovarian vein compresses the ureter. This causes chronic or colicky abdominal pain, back pain and/or pelvic pain. The pain can worsen on lying down or between ovulation and menstruation. There can also be an increased tendency towards urinary tract infection or pyelonephritis. The right ovarian vein is most commonly involved, although the disease can be left-sided or affect both sides. It is currently classified as a form of pelvic congestion syndrome.

<span class="mw-page-title-main">Syncope (medicine)</span> Transient loss of consciousness and postural tone

Syncope, commonly known as fainting, or passing out, is a loss of consciousness and muscle strength characterized by a fast onset, short duration, and spontaneous recovery. It is caused by a decrease in blood flow to the brain, typically from low blood pressure. There are sometimes symptoms before the loss of consciousness such as lightheadedness, sweating, pale skin, blurred vision, nausea, vomiting, or feeling warm. Syncope may also be associated with a short episode of muscle twitching. Psychiatric causes can also be determined when a patient experiences fear, anxiety, or panic; particularly before a stressful event, usually medical in nature. When consciousness and muscle strength are not completely lost, it is called presyncope. It is recommended that presyncope be treated the same as syncope.

<span class="mw-page-title-main">Cerebrospinal fluid leak</span> Medical condition

A cerebrospinal fluid leak is a medical condition where the cerebrospinal fluid (CSF) surrounding the brain or spinal cord leaks out of one or more holes or tears in the dura mater. A cerebrospinal fluid leak can be either cranial or spinal, and these are two different disorders. A spinal CSF leak can be caused by one or more meningeal diverticula or CSF-venous fistulas not associated with an epidural leak.

<span class="mw-page-title-main">Median arcuate ligament syndrome</span> Medical condition

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Orthostatic syncope refers to syncope resulting from a postural decrease in blood pressure, termed orthostatic hypotension.

Prehospital ultrasound is the specialized application of ultrasound by paramedics, to guide immediate care and treatment procedures. Like conventional ultrasound, it is a device that produces cyclic sound pressure to penetrate a medium (flesh) and reveal details about the inner structure of the medium.

Signs and symptoms of pregnancy are common, benign conditions that result from the changes to the body that occur during pregnancy. Signs and symptoms of pregnancy typically change as pregnancy progresses, although several symptoms may be present throughout. Depending on severity, common symptoms in pregnancy can develop into complications. Pregnancy symptoms may be categorized based on trimester as well as region of the body affected.

References

  1. Kiefer R, Ploppa A, Dieterich H (2003). "[Aortocaval compression syndrome]". Der Anaesthesist. 52 (11): 1073–83, quiz 1084. doi:10.1007/s00101-003-0596-6. PMID   14992095. S2CID   8424182.
  2. Banaś T, Godula Z, Herman R (2004). "[Aortocaval compression syndrome as an explanation of sudden intrauterine death of mature twins at term. Case report]". Ginekol Pol. 75 (8): 633–7. PMID   15517787.
  3. American Academy of Orthopaedic Surgeons (2018). Nancy Caroline's Emergency Care in the Streets (8th ed.). Jones & Bartlett Publishers. p. 2036.
  4. Zhao, Pei-Shan (September 1, 2014). "Supine Hypotensive Syndrome: A Comprehensive Review of Literature". Translational Perioperative and Pain Medicine. Transpopmed. Retrieved December 29, 2023.
  5. SW, Lee; KS, Khaw; WD, Ngan Kee; TY, Leung; LA, Critchley (2012). "Haemodynamic effects from aortocaval compression at different angles of lateral tilt in non-labouring term pregnant women". British Journal of Anaesthesia. Br J Anaesth. 109 (6): 950–956. doi: 10.1093/bja/aes349 . ISSN   1471-6771. PMID   23059960.

Further reading