Venous Thoracic Outlet Syndrome
Venous thoracic outlet syndrome (TOS) is a condition that happens when the subclavian vein is squeezed or compressed. The subclavian vein is the vein that returns blood from the arm and hand to the heart. To reach the arm, this vein must pass through the thoracic outlet. This is a tight space under the collarbone (clavicle) and above the top rib.
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 doing hard work with your arms, especially if you have to lift your arms above your head. A blood clot may form in the vein.
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 swelling of your whole arm.
A feeling of heaviness or tightness in your arm.
Weak or absent pulse in the affected arm.
Pale or gray skin on the affected arm.
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:
Medicine, including blood thinners or blood clot dissolvers.
A procedure to open up the clotted vein and restore blood flow (angioplasty).
Surgery to remove a blood clot (thrombus).
Surgery to remove the uppermost rib to make more space in the thoracic outlet.
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 skin 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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Venous thoracic outlet syndrome (TOS) is a condition that happens when the subclavian vein, which returns blood from the arm and hand to the heart, is squeezed or compressed.
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This condition may be caused by doing hard work with your arms, especially if you have to lift them above your head.
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Symptoms include pain and swelling of your whole arm, weak or absent pulse in the affected arm, and pale or gray skin on the affected arm.
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Treatment may include medicines, a procedure to restore blood flow (angioplasty), surgery to remove a blood clot, or surgery to remove the uppermost rib to make more space in the thoracic outlet.
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.