Ms. Mien, a 48-year-old woman, experienced numbness in her right fingers, a tired arm, and occasional cold right hand. She visited a doctor who diagnosed her with a rare thoracic outlet syndrome (TOS). This condition occurs when blood vessels or nerves in the upper body are compressed by surrounding structures, leading to various symptoms like tingling, muscle weakness, and pain in the neck, shoulders, arms, or hands.
Dr. Nguyen Anh Dung, Head of the Department of Cardiovascular and Thoracic Surgery at Tam Anh General Hospital in Ho Chi Minh City explained that Ms. Mien had severe stenosis of the right subclavian artery root and the subclavian veins on both sides. It was suspected to be due to TOS. TOS is divided into three types: neurogenic TOS, venous TOS and arterial TOS.
To treat Ms. Mien’s condition, a surgical team performed a procedure to widen the thoracic outlet by cutting the anterior bundle of the scalene muscle. The surgery was successful and Ms. Mien experienced immediate relief from her symptoms following it. She was advised to follow a healthy lifestyle to prevent stress on her shoulders and the muscles around the thoracic outlet after surgery.
The cause of thoracic outlet syndrome can be attributed to various factors such as trauma, congenital anatomical abnormalities, bad posture, repetitive movements and obesity. People at risk include office workers, athletes, musicians mechanics and others who perform repetitive movements or lift heavy objects incorrectly.
It is important for patients suffering from TOS to seek treatment because complications like chronic pain swelling or blood clots could arise if left untreated.
Physical therapy is often considered as first line treatment for TOS along with medications that manage symptoms.
If conservative treatments are unsuccessful surgery may be recommended.
Patients should also practice good posture maintain a healthy weight avoid activities that exacerbate symptoms regular exercise stretching can help strengthen shoulder muscles reduce pressure on thoracic outlet
