Persisting Pressure in Neck and Head
F32. Last Wednesday, while receiving intravenous fluids via my SmartPort located on the left side, an unexpected sensation of pressure developed in both my neck and head. This feeling subsided when the infusion was halted, yet it recurred once the treatment resumed. Since that incident, I've noticed the same uncomfortable pressure whenever I exert myself, walk, eat, bend over, or lie flat. I visited the emergency room on Friday. A chest X-ray indicated that my lines were correctly positioned, and a non-contrast CT scan of my head showed no abnormalities, as I am allergic to iodine contrast. I was released from the hospital, but the headaches persisted. On Monday, during my regular plasma exchange through my dialysis port in the right side of my chest, I encountered the same constricting pressure once more. I have reached out to my hematologist, cardiologist, and vascular specialist but have yet to receive any feedback. My medical background includes the following conditions: • Factor V Leiden • Previous right atrial thrombus (September 2024, necessitated emergency thrombectomy) • Right jugular vein DVT (October 2024) • Warfarin anticoagulation therapy (recent INR reading of 6.4 last Tuesday adjusted to 1.9 on Friday; target range is between 2.5 and 3.5) • Myasthenia Gravis • Lupus • Chronic anemia At present, I am dealing with symptoms such as: • Pressure in the neck and head • Facial swelling • Hoarseness • Lightheadedness • Difficulty breathing • Symptoms worsening with physical activity, exertion, or during meals Could these issues indicate SVC (Superior Vena Cava) syndrome? Considering my history of blood clots and anticoagulant complications, should I return to the emergency department? Or might this signify another underlying issue? What diagnostic examinations should I consider requesting?
Answers (1)
8/26/2025, 5:16:14 PM
OpenHealth AI
It's understandable to be concerned about the persistent pressure you're experiencing in your neck and head, especially given your complex medical history. The symptoms you're describing, including facial swelling, hoarseness, lightheadedness, and difficulty breathing, are significant and could suggest an urgent condition such as Superior Vena Cava (SVC) syndrome.
Explanation
SVC syndrome occurs when there's obstruction of the superior vena cava, which can result from a variety of conditions, including blood clots, tumors, or other vascular issues. Given your history of blood clots and current anticoagulant therapy, it's essential to take your symptoms seriously.
Even though you've recently had imaging studies that didn't show any abnormalities, the recurring and worsening symptoms, especially during exertion or when lying flat, warrant further evaluation. This is particularly important considering your recent high INR levels and the complexities of your medical conditions.
Immediate Steps
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Return to the Emergency Department: Given the combination of your symptoms and your medical history, returning to the emergency department is advisable. Explain all your symptoms, particularly the new developments since your last visit.
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Seek Prompt Medical Attention: If you experience increased difficulty breathing, worsening lightheadedness, or any significant changes in your health (like sudden swelling or a feeling of impending doom), seek immediate care.
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Symptom Documentation: Keep a log of your symptoms, noting when they occur, their severity, and any triggers (like bending over or physical exertion). This information will be useful for the healthcare providers evaluating you.
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Continue Seeking Feedback: While waiting for responses from your specialists, it might be beneficial to follow up with them again. Specifically, ask about a referral to a vascular specialist or more immediate imaging studies (like a Doppler ultrasound or MRI) that could help clarify any vascular concerns.
Reassurance
I understand this situation is distressing, especially with your underlying health conditions. It's important you advocate for yourself and ensure your concerns are taken seriously during your next medical encounter. Don't hesitate to express the urgency of your symptoms. Your health and well-being are paramount, and it’s crucial to follow up effectively.
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