Surgery demonstrates symptom improvement in a patient with chest pain and neurogenic thoracic outlet syndrome, suggesting further evaluation is needed.
A 41-year-old woman with a 1-year history of right chest pain, with normal cardiology and pulmonology assessments. The chest pain was reproducible upon upper limb elevation. Computed tomography (CT) angiography in the arm-elevated position revealed subclavian artery and vein stenosis at the costoclavicular space, and the diagnosis was neurogenic thoracic outlet syndrome (TOS). Surgery involving endoscopic-assisted infraclavicular resection of the first rib and scalene muscles resulted in immediate postoperative symptom improvement. When chest pain persists after ruling out other conditions, neurogenic TOS should be considered in the differential diagnosis.
No takes yet. Share an insight, caveat, or question.
Makita et al. (2025) studied this question.
Synapse has enriched 3 closely related papers on similar clinical questions. Consider them for comparative context: