MEDLINE Journals

    Arm edema, subclavian thrombosis, and pacemakers--a case report.

    Ciocon JO, Galindo-Ciocon D 
    Angiology 1998 Apr; 49(4) :315-9.

    This reports an arm edema that was initially treated as cellulitis and later diagnosed to be subclavian thrombosis due to pacemaker wire irritation. We present an 87-year-old Caucasian man with 5 weeks duration of left arm swelling and pain that was treated with two courses of antibiotics. An axillary venous Doppler study was interpreted as normal with no evidence of venous thrombosis. However, a venogram showed evidence of thrombosis involving the left innominate, subclavian, and axillary veins with multiple collateral veins diverting the blood to the contralateral side and into the superior vena cava. Intravenous anticoagulation was initiated and subsequently the patient was maintained on warfarin (Coumadin). The thrombosis subsequently improved and the original pacemaker was maintained. Arm edema are commonly mistaken for cellulitis, causing a delay in a more definite diagnosis of subclavian thrombosis. In a setting of a patient with pacemaker, subclavian thrombosis should be considered even with a normal screening venous ultrasound test. The incidence, manifestation, venous Doppler, and venogram findings are reviewed and discussed. Upper arm edema and superior vena cava syndrome are the most common presentation of this subclavian thrombosis associated with pacemakers. Venous ultrasound tests may be normal and a venogram is usually required to establish a diagnosis.

    Aged, 80 and over
    Axillary Vein
    Brachiocephalic Veins
    Collateral Circulation
    Diagnosis, Differential
    Injections, Intravenous
    Pacemaker, Artificial
    Subclavian Vein
    Superior Vena Cava Syndrome
    Ultrasonography, Doppler
    Vena Cava, Superior


    Pub Type(s)
    Case Reports Journal Article Review
    PubMed ID


    Content Manager
    Related Content

    A painful swollen arm in a young woman.

    [Color Doppler and phlebography in the Paget-Schroetter syndrome].

    [A case of superior vena cava syndrome due to extensive venous thrombosis of an idiopathic nature].

    Limb loss due to transvenous endocardial pacemaker therapy.

    [Superior vena cava syndrome unrelated to central venous catheter in a patient on chronic hemodialysis].

    Echographic detection of latent severe thrombotic stenosis of the superior vena cava and innominate vein in patients with a pacemaker: integrated diagnosis using sonography, pulse Doppler, and color flow.

    Major venous thrombosis: a complication of transvenous pacemaker electrodes.

    [Thrombophlebitis on intravenous cardiac stimulator electrodes].