MEDLINE Journals

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

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

    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.

    Mesh
    Aged
    Aged, 80 and over
    Anticoagulants
    Arm
    Axillary Vein
    Brachiocephalic Veins
    Cellulitis
    Collateral Circulation
    Diagnosis, Differential
    Edema
    Humans
    Incidence
    Injections, Intravenous
    Male
    Pacemaker, Artificial
    Pain
    Subclavian Vein
    Superior Vena Cava Syndrome
    Thrombosis
    Ultrasonography, Doppler
    Vena Cava, Superior
    Warfarin
    Language

    eng

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

    9555935

    Content Manager
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