Useful Triad for Diagnosing the Cause of Chest Pain

Selmonosky, Carlos A.; Byrd, Randy; Blood, Cynthia; Blanc, James

doi:10.1097/00007611-198108000-00015

Cited by 8 publications

(4 citation statements)

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“…With regard to TOS itself, its elaborated diagnostic protocols are outside of the main scope of this article. However, we have used a modified version of Selmonosky's diagnostic triad 68,69,70,71 to diagnose TOS on these patients: Clinical presentation should have common denominators with TOS' symptomology, although the brachial aspect may or may not be the most dominant ones. Chest pain, brachialgia, dyspnea, and periscapular pain are common symptoms in TOS.…”

Section: Diagnostic Approachesmentioning

confidence: 99%

Does thoracic outlet syndrome cause cerebrovascular hyperperfusion? Diagnostic markers for occult craniovascular congestion

Larsen

Galluccio

Chand³

2020

APIC

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Thoracic outlet syndrome (TOS) is known to be associated with diffuse craniological comorbidities (CCM), such as occipital headaches, migraines, vestibular dysfunction, tinnitus and fatigue. Conventionally, these problems have been suggested to be a manifestation of positional vertebrobasilar insufficiency. Angiography tends to be normal in TOS sufferers, however, and doppler ultrasonography of the vertebral artery fails to demonstrate severe flow reduction. TOS is attributed to the brachial plexus and subclavian artery being compressed in the interscalene triangle, costoclavicular or subpectoral passages. The vertebral and carotid arteries arise from subclavian artery proximal to the sites of obstruction in TOS. Numerous reports of resolved CCM post-scalenectomy and first-rib resection, despite lacking vertebral artery impairment, have been documented. TOS CCM, moreover, share many of the symptoms seen in systemic and intracranial hypertension. Reports of subclavian thromboembolus migrating to the head have been documented in incidences of TOS, showing the potential for flow retrogradation. We postulate that the blood prevented from entering the brachium due to distal subclavian compression, retrogrades to the brain via the carotid and vertebral arteries, resulting in craniovascular hyperperfusion and congestion. Abbreviations: Thoracic outlet syndrome: TOS, Vertebral artery: VA, Vertebrobasilar insufficiency: VBI, Cerebrovascular hyperperfusion: CVH, Blood-brain barrier: BBB, Myalgic encephalomyelitis: ME, “Time of flight”: TOF, Citation: Larsen K, Galluccio FC, Chand SK. Does thoracic outlet syndrome cause cerebrovascular hyperperfusion? Diagnostic markers for occult craniovascular congestion. Anaesth pain intensive care 2020;24(1)___ Received – 30 November 2019; Reviewed – 2, 6 February 2019; Accepted – 27 February 2019;

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Section: Diagnostic Approachesmentioning

confidence: 99%

Does thoracic outlet syndrome cause cerebrovascular hyperperfusion? Diagnostic markers for occult craniovascular congestion

Larsen

Galluccio

Chand³

2020

APIC

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“…LPES may frequently present with distal symptoms, likely to mislead the practitioner. For example, similarly, it is known that TOS patients may present with seemingly unrelated symptoms, such as carpal tunnel syndrome, 49 chest pain, 50 shoulder pain, 51 brachialgia, 52 or periscapular pain. 53 Entrapmentinduced dysautonomia has also been implicated in TOS.…”

Section: Lumbosacral Plexus Entrapment Syndromementioning

confidence: 99%

“…This is infrequent in LPES sufferers. Thus, some force should be used when performing these tests, looking for "relative weakness", as Selmonosky 50,51,81 describes when searching for TOS. Hip flexion (L1-2), knee extension (L3), ankle dorsiflexion (L4) great toe extension (L5), foot eversion (S1), knee flexion (S2) are all viable tests when evaluating the severity of LPES.…”

Section: Neurographymentioning

confidence: 99%

Lumbosacral plexus entrapment syndrome. Part one: A common yet little-known cause of chronic pelvic and lower extremity pain

Larsen¹,

Chien

2019

APIC

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Lumbosacral plexus entrapment syndrome (LPES) is a little-known but common cause of chronic lumbopelvic and lower extremity pain. The lumbar plexus, including the lumbosacral tunks emerge through the fibers of the psoas major, and the proximal sciatic nerve beneath the piriformis muscles. Severe weakness of these muscles may lead to entrapment plexopathy, resulting in diffuse and non-specific pain patterns throughout the lumbopelvic complex and lower extremities (LPLE), easily mimicking other diagnoses and is therefore likely to mislead the interpreting clinician. It is a pathology very similar to that of thoracic outlet syndrome, but for the lower body. This two-part manuscript series was written in an attempt to demonstrate the existence, pathophysiology, diagnostic protocol as well as interventional strategy for LPES, and its efficacy.Piriformis syndrome; Nerve entrapment; Double-crush; Pain, Chronic; Fibromyalgia Citation: Larsen K, Chien GCC. Lumbosacral plexus entrapment syndrome. Part one: A common yet little-known cause of chronic pelvic and lower extremity pain. Anaesth pain & intensiv care 2019;23(2):124-137

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“…A veces el diagnóstico puede no ser tan claro, como ocurre cuando existe la asociación de un SOT con otras enfermedades. Su asociación con reflujo gastrointestinal y algunas enfermedades cardíacas ha sido reportada por algunos autores como cercana al 40% 5 .…”

Section: Introductionunclassified

El diagnóstico del síndrome del opérculo torácico: Mitos y realidades

Selmonosky

S²

2008

Rev Chil Cir

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Useful Triad for Diagnosing the Cause of Chest Pain

Cited by 8 publications

References 0 publications

Does thoracic outlet syndrome cause cerebrovascular hyperperfusion? Diagnostic markers for occult craniovascular congestion

Does thoracic outlet syndrome cause cerebrovascular hyperperfusion? Diagnostic markers for occult craniovascular congestion

Lumbosacral plexus entrapment syndrome. Part one: A common yet little-known cause of chronic pelvic and lower extremity pain

El diagnóstico del síndrome del opérculo torácico: Mitos y realidades

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