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

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

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

The inferior vena cava is a large vein that carries the deoxygenated blood from the lower and middle body into the right atrium of the heart. It is formed by the joining of the right and the left common iliac veins, usually at the level of the fifth lumbar vertebra.

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

Hypotension, also known as low blood pressure, is a cardiovascular condition characterized by abnormally reduced blood pressure. Blood pressure is the force of blood pushing against the walls of the arteries as the heart pumps out blood and is indicated by two numbers, the systolic blood pressure and the diastolic blood pressure, which are the maximum and minimum blood pressures within the cardiac cycle, respectively. A systolic blood pressure of less than 90 millimeters of mercury (mmHg) or diastolic of less than 60 mmHg is generally considered to be hypotension. Different numbers apply to children. However, in practice, blood pressure is considered too low only if noticeable symptoms are present.

<span class="mw-page-title-main">Budd–Chiari syndrome</span> Blockage of the hepatic veins that drain the liver

Budd–Chiari syndrome is a very rare condition, affecting one in a million adults. The condition is caused by occlusion of the hepatic veins that drain the liver.

<span class="mw-page-title-main">Abdominal pain</span> Stomach aches

Abdominal pain, also known as a stomach ache, is a symptom associated with both non-serious and serious medical issues. Since the abdomen contains most of the body's vital organs, it can be an indicator of a wide variety of diseases. Given that, approaching the examination of a person and planning of a differential diagnosis is extremely important.

<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 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. Symptoms including high venous pressure in the lower limbs, decreased blood return to the heart, decreased cardiac output, placental separation and decreased kidney function have been observed in late term pregnancy. Studies show that all of these issues can arise from lying in the supine position during late pregnancy, which can cause compression and obstruction 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

May–Thurner syndrome (MTS), also known as the iliac vein compression syndrome, is a condition in which compression of the common venous outflow tract of the left lower extremity may cause discomfort, swelling, pain or iliofemoral deep vein thrombosis.

<span class="mw-page-title-main">Nutcracker syndrome</span> Compression of the left renal vein, restricting bloodflow from the left kidney

The nutcracker syndrome (NCS) results most commonly from the compression of the left renal vein (LRV) between the abdominal aorta (AA) and superior mesenteric artery (SMA), although other variants exist. The name derives from the fact that, in the sagittal plane and/or transverse plane, the SMA and AA appear to be a nutcracker crushing a nut.

<span class="mw-page-title-main">Abdominal angina</span> Medical condition

Abdominal angina is abdominal pain after eating caused by a reduction of blood flow to the celiac trunk, superior mesenteric arteries (SMA), inferior mesenteric artery (IMA), or the surrounding organs. Symptoms include abdominal pain, weight loss, diarrhea, nausea, vomiting, and an aversion or fear of eating caused by the pain associated with eating.

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The pampiniform plexus is a venous plexus – a network of many small veins found in the human male spermatic cord, and the suspensory ligament of the ovary. In the male, it is formed by the union of multiple testicular veins from the back of the testis and tributaries from the epididymis.

Emergency ultrasound employing point-of-care ultrasound (POCUS) is the application of ultrasound at the point of care to make immediate patient-care decisions. It is performed by the health care professional caring for the injured or ill persons. This point-of-care use of ultrasound is often to evaluate an emergency medical condition, in settings such as an emergency department, critical care unit, ambulance, or combat zone.

<span class="mw-page-title-main">Ovarian vein syndrome</span> Pinching of the ureter due to widening of the ovarian vein

Ovarian vein syndrome is a rare condition in which dilation of the 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> Leakage of fluid surrounding the brain and spinal cord through tears in the dura mater

A cerebrospinal fluid leak is a medical condition where the cerebrospinal fluid (CSF) that surrounds the brain and spinal cord leaks out of one or more holes or tears in the dura mater. A CSF leak is classed as either spontaneous (primary), having no known cause, or nonspontaneous (secondary) where it is attributed to an underlying condition. Causes of a primary CSF leak are those of trauma including from an accident or intentional injury, or arising from a medical intervention known as iatrogenic. A basilar skull fracture as a cause can give the sign of CSF leakage from the ear, nose or mouth. A lumbar puncture can give the symptom of a post-dural-puncture headache.

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

In medicine, the median arcuate ligament syndrome is a rare condition characterized by abdominal pain attributed to compression of the celiac artery and the celiac ganglia by the median arcuate ligament. The abdominal pain may be related to meals, may be accompanied by weight loss, and may be associated with an abdominal bruit heard by a clinician.

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

Preureteric vena cava or retrocaval ureter is an uncommon congenital anomaly where the right ureter runs behind and medial to the inferior vena cava (IVC) due to dysgenesis of the IVC. This abnormality has been diagnosed using computed tomography urography (CTU), nuclear scintigraphy, ultrasound, intravenous urography, and magnetic resonance urography (MRU). When the illness manifests symptoms, surgery, either open or laparoscopic, is used to treat it.

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.

Prenatal dental care is the care of the oral cavity during fetal development. The woman’s body is subject to hormonal changes leading to several physical changes in the oral cavity during pregnancy. Some of these changes may cause tooth decay, erosion and periodontal health changes.

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. 109 (6). Br J Anaesth: 950–956. doi: 10.1093/bja/aes349 . ISSN   1471-6771. PMID   23059960.

Further reading