Arterial Thoracic Outlet Syndrome

Abstract

Arterial thoracic outlet syndrome is a rare cause of shoulder pain due to compression of the subclavian or axillary artery within the thoracic outlet. It is the least common form of thoracic outlet syndrome but is potentially dangerous as it can result in significant morbidity. An athlete initially may present with exertional pain, early fatigability, a dull ache, or discomfort in the affected arm. History and physical examination are paramount in diagnosis, and imaging confirms the anatomy. Surgical repair or resection alleviates the compression of the affected structure and allows for a safe return to participation. Familiarity with this condition aids in the prompt diagnosis and treatment of this disorder.

Arterial Thromboembolism Secondary to Thoracic Outlet Syndrome

“…Furthermore, if the patient has already developed collaterals due to chronic distal embolization of the arterial and ulnar arteries, an abrupt lack of pulse might be difficult to discern on physical exam. Patients may complain of exertional pain in the affected extremity that worsens with movement and improves with rest [8].…”

Síndrome do desfiladeiro torácico: uma revisão narrativa.

“…The symptomatology of the patient with TOS depends primarily on the pathophysiological mechanism involved in the syndrome 3 . Daniels et al 5 There is still no consensus on the use and diagnostic accuracy of clinical maneuvers as the gold standard in the diagnosis of TOS 6 . This is justified by the low positive predictive value of the maneuvers.…”

“…TOS is a rare and potentially serious syndrome that affects young adults, usually between 20 and 40 years old, with a mem-woman ratio 1:4, which results in significant morbidity if not treated [3][4][5] .…”

Thoracic outlet syndrome: a congenital case manifesting in middle age

“…1 In these cases, ischemia in the upper extremity occurs, with pallor, pain, paresthesias and changes in distal pulses, as well as decreased systolic blood pressure and auscultatory bruits.…”

“…1 The differential diagnosis includes artery atherosclerosis in the upper limb, Raynaud phenomenon, vasculitis, vasospastic disorder, carpal tunnel syndrome and acute coronary syndrome.…”