PMID: 9555935Apr 29, 1998Paper

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

Angiology
J O Ciocon, D Galindo-Ciocon

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 subc...Continue Reading

References

Feb 1, 1979·Circulation·S M Prescott, G Tikoff
Aug 1, 1976·The Annals of Thoracic Surgery·W S StoneyC S Thomas
Feb 1, 1994·Pacing and Clinical Electrophysiology : PACE·G M PalatianosG N Sfakianakis
May 1, 1997·Annals of Internal Medicine·I MartinelliP M Mannucci

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Citations

Mar 7, 2007·Pacing and Clinical Electrophysiology : PACE·Petri KorkeilaK E Juhani Airaksinen
Jul 24, 2012·Pacing and Clinical Electrophysiology : PACE·Saroj MandalManotosh Panja
May 20, 2009·Clinical Orthopaedics and Related Research·Santiago L BongiovanniGaston D Maignon

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