Arterial Thoracic Outlet Syndrome
Arterial thoracic outlet syndrome (TOS) is a condition that happens when the subclavian artery is squeezed or compressed. The subclavian artery is the artery that carries blood from the heart to the arm and hand. To reach the arm, this artery must pass through the thoracic outlet, which is a tight space under the collarbone (clavicle) and above the top rib. There are different types of TOS, and the arterial type is the rarest.
Depending on which structures are affected, you may have symptoms on one or both sides of your body.
What are the causes?
This condition may be caused by having a cervical rib. This is an extra rib at the base of your neck that presses on your subclavian artery. Over time, this pressure may cause a clot to form inside the artery, or the artery may weaken and balloon outward (aneurysm).
What increases the risk?
The following factors may make you more likely to develop this condition:
What are the signs or symptoms?
Symptoms of this condition include:
Pain and cramps in your arm or hand.
Pale skin or a change in color of the skin on your hand and arm.
Very cold hands.
Muscle loss in your hands. This is rare.
These signs and symptoms may be worse when you hold your arms over your head.
How is this diagnosed?
This condition may be diagnosed based on:
How is this treated?
This condition may be treated with surgery to:
Treatment may also include:
A procedure to open up the clotted vein and restore blood flow (angioplasty).
Medicine, including blood thinners or blood clot dissolvers.
Follow these instructions at home:
Medicines
Activity
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Do exercises as told by your health care provider or physical therapist.
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Do not lift anything that is heavier than 10 lb (4.5 kg), or the limit that you are told, until your health care provider says that it is safe.
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Do not carry heavy bags over your shoulder or repetitively lift heavy objects over your head.
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Take breaks often to stretch and rest your arms if you work at a keyboard or do other repetitive work with your hands and arms.
General instructions
Contact a health care provider if:
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You have pain, cramps, numbness, or tingling in your arm or hand.
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Your arm or hand often feels tired.
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Your arm turns a darker and different color than usual.
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Your hand feels cold.
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You have frequent headaches or neck pain.
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You have muscle loss in your hand.
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You lose feeling in your arm or hand.
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You cannot move your fingers.
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Your fingers turn a dark color.
Summary
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Arterial thoracic outlet syndrome (TOS) is a condition that happens when the subclavian artery is squeezed or compressed. This artery carries blood from the heart to the arm and hand.
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This condition may be caused by having a cervical rib, which is an extra rib at the base of your neck that presses on your subclavian artery.
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Symptoms include pain and cramps in your arm or hand, pale skin or a change in color of the skin on your hand and arm, very cold hands, and muscle loss in your hands.
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This condition may be treated with surgery, a procedure to restore blood flow (angioplasty), or medicines.
This information is not intended to replace advice given to you by your health care provider. Make sure you discuss any questions you have with your health care provider.