Case history
Case history #1
A 65-year-old man with a 40-year history of chronic smoking, hypertension, and chronic obstructive pulmonary disease presents with anorexia and weight loss for the past 6 months. He had been complaining of increased dyspnea with exertion and orthopnea, and has noticed bilateral arm swelling and facial plethora for the past 3 weeks. At the time of admission, his face and upper extremities were edematous, and there were engorged veins in his neck and upper extremity.
Case history #2
A 70-year-old woman with a history of ischemic cardiomyopathy, left ventricular ejection fraction of 25%, and prior history of cardiac resynchronization therapy 3 years ago presents with slowly progressive swelling of the face and both arms, as well as prominent veins in the neck and upper extremities. She gives a history of excessive bleeding from the site of venepuncture in the antecubital region after blood draws in the last few months.
Other presentations
Atypical presentations may include presentation to the emergency department with sudden-onset dyspnea due to laryngeal edema that can be acutely fatal due to upper airway compromise.[5] In addition, cyanosis, papilledema, cerebral edema, mental changes, stupor, and even coma have been described with severe obstruction.[1][6]
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