Thoracic Outlet Syndrome
Thoracic outlet syndrome (TOS) is a condition caused by compression of nerves or blood vessels in the thoracic outlet, the area between the base of the neck and the armpit, including the front of the shoulders and chest.
Thoracic outlet syndrome affects people of all ages and gender. It could be caused by abnormal anatomy (like having an extra first rib) from birth or dues to trauma caused by repetitive motion of shoulder and arms like athletes or people who train for extreme strength training including police men.
The TOS caused by compression of nerves is neurogenic TOS and is the most common type of TOS.
At Vora vein and PAD Clinic, we follow patients with TOS of vascular origin. Vascular TOS could be either venous or arterial and is less commonly seen.
Venous TOS is caused by compression of subclavian vein between first rib and collarbone. This may lead to blood clot. The condition develops suddenly and immediate treatment is critical.
Arterial TOS is rare as well and is caused by compression of subclavian artery. Based on location at which the compression occurs, another condition called subclavian steal syndrome. Arterial TOS may also cause stenosis.
So, based on the organs and vascularity involved the symptoms vary. Symptoms include pain, numbness, tingling, swelling, fatigue and blue discoloration.
Diagnosis of TOS requires taking extensive history and physical exam. An ultrasound exam, CT or MRI imaging will further be required.
Treatment for mild form of thoracic outlet syndrome usually involves physical therapy and pain relief measures. Venous TOS requires thrombolysis, anticoagulation therapy and then surgery to decompress the thoracic outlet. Arterial TOS may require stenting of the artery if stenosis is involved.