Elsevier

Joint Bone Spine

Volume 71, Issue 5, September 2004, Pages 430-432
Joint Bone Spine

Case report
A novel finding in thoracic outlet syndrome: tachycardia

https://doi.org/10.1016/j.jbspin.2003.07.007Get rights and content

Abstract

In this case report, we rendered a 22 year old woman with the diagnosis of neurogenic thoracic outlet syndrome. We have evaluated her symptoms of palpitation with Holter monitorization during Roos test before and after surgery where transaxillary first rib resection and scalenectomy were performed. Postoperatively she improved and the tachycardia resolved. We propose that stellate ganglion or postganglionic efferent sympathetic fibers forming the cardiac plexus are exposed to compression while Roos test is being performed. Due to this irritation, there can be an increase in the cardiac sympathetic activity.

Introduction

There are many well known neurological complications of thoracic outlet syndrome (TOS). Sympathetic nervous system problems of the upper extremities such as vasomotor changes, complex regional pain syndrome and hyperhidrosis may be observed due to the compression of the sympathetic nerve fibers of the brachial plexus [1]. However, sympathetic nervous system of the heart may also be affected in these patients. To our notice, there is only one case report describing such a complication in the literature [2], thus we present another patient and further discuss its mechanisms.

Section snippets

Case report

A 22 year old woman applied to our physical medicine and rehabilitation clinic with the complaints of pain, numbness in her both arms, weakness in her right hand and palpitation episodes for the last 4 years. She described her symptoms of pain—especially originating from her right shoulder going down to the right hand—and numbness in the medial side of her right forearm as well as her fingers of the right hand. She claimed that she mainly suffered from these symptoms when she was working with

Discussion

Pure neurogenic TOS is a rare entity with an incidence of 1/1,000,000[4] where motor and sensory nerves, sympathetic nerves can be affected. Due to the compression of sympathetic fibers of the brachial plexus; hyperhydrosis, Raynaud’s phenomenon, Raynaud’s disease, complex regional pain syndrome or vascular insufficiency can be seen [1]. Gockel et al. [5] found out that heart rate values were higher in TOS patients than the normal healthy controls, however, in the literature irritation of

References (8)

There are more references available in the full text version of this article.

Cited by (0)

View full text