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Vascular thoracic outlet in a competitive swimmer: a case report.
[thoracic outlet syndrome]
Thoracic
outlet
syndrome
(
TOS
)
is
a
well-described
condition
resulting
from
compression
of
the
brachial
plexus
,
subclavian
artery
and
/
or
vein
.
Though
symptoms
of
pain
,
numbness
,
tingling
and
signs
of
muscular
weakness
associated
with
this
condition
usually
begin
insidiously
,
on
rare
occasions
the
presentation
is
of
acute
onset
and
may
represent
an
acute
vascular
compression
.
An
unusual
form
of
"
effort
"
thrombosis
of
the
subclavian
vein
may
require
emergency
care
in
order
to
ensure
controlled
clot
lysis
and
thrombus
dissolution
.
Confirmation
of
subclavian
thrombus
is
obtained
by
venography
and
makes
use
of
real
time
videography
to
assess
for
venous
flow
impairment
.
Definitive
treatment
for
the
underlying
cause
of
this
form
of
TOS
is
first
rib
resection
and
scalenectomy
.
This
case
report
presents
a
competitive
swimmer
who
developed
an
acute
onset
of
limb
cyanosis
and
turgidity
during
swim
training
.
Awareness
of
the
possibility
of
acute
thrombosis
obstructing
venous
return
and
producing
such
signs
and
symptoms
should
lead
the
astute
clinician
to
consider
recommending
contrast
venography
to
assess
the
lesion
and
lead
to
appropriate
medical
intervention
.
