Strong Heart and Vascular Center
Division of Vascular Surgery
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Thoracic Outlet Syndrome
What is Thoracic Outlet Syndrome?
The thoracic outlet is the
area between the base of the neck and armpit through which
the blood vessels and nerves pass. Thoracic outlet syndrome
(TOS)
is a condition that arises from pressure
being placed on nerves or blood vessels. Pressure on the blood vessels
can result in blood
clots in the major
veins
of the
arm.
The result is pain in the arm, neck, or shoulder.
TOS is sometimes associated with a congenital abnormality of
an extra
rib (or "cervical rib"). There may be
a
history of a traumatic blow to the shoulder or neck. Poor posture
and obesity can also aggravate this condition,
which is more common among women than
men.
Causes and risk factors for Thoracic Outlet Syndrome
Symptoms of Thoracic Outlet Syndrome
The symptoms of TOS vary depending on whether nerves, arteries,
or
veins in the thoracic outlet are compressed.
Although symptoms vary depending on whether a nerve or blood
vessel has been affected, many times more than one system (nerves,
veins, arteries) is involved. Diagnosing TOS can also be difficult
since many other conditions cause similar symptoms (for example:
carpal tunnel syndrome,
shoulder tendonitis, cervical disc disease and fibromyalgia.
Symptoms a health care provider will be looking for include...
-
Reduced pulse in the arm when the arm is held in certain
overhead positions or while turning the head far to one side
-
Swelling of the arm
-
Very prominent veins in the arm
-
Discoloration of the fingers
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Limited range of motion for the arm
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Reduced ability to feel pinpricks or temperature changes
-
Abnormal blood vessel sounds during a stethoscope examination
of the shoulder area
To confirm whether or not a patient has TOS, the following tests
may be performed...
Treatment Options
Treatment for TOS depends on the symptoms.
If an extra rib is present, or there are problems
with arm artery or vein are present, these underlying causes
will be treated first, otherwise, the usual first treatment is
In severe cases...
