Venous Thoracic Outlet Syndrome
Pathology
- Unilateral arm swelling without thrombosis
- May be due to subclavian vein compression when not caused by lymphatic obstruction
- Paget-von Schrotter syndrome = thrombosis of the subclavian vein
Signs and Symptoms
- Often in younger men and typically preceded by excessive activity in the arms or can occur spontaneously
- Excruciating deep pain in the chest, shoulder, and entire upper extremity
- Edema of the upper extremity (asymmetrical or bilateral)
- Cyanosis
- Feeling of heaviness (especially following activity) in upper extremity
- Paresthesias in the fingers and hand (secondary to edema)
- Venous engorgement with collateralization of peripheral vessels
- Axillary or subclavian vein thrombosis
- Pulmonary embolism
(Hooper et. al., 2010; Huang & Zager, 2004; Watson et. al., 2009)