Venous Thoracic Outlet Syndrome

This case describes a 36-year-old woman who developed swelling and bluish discoloration of her left arm when raising it, triggered after prolonged desk work. CT showed no thrombosis. Venography revealed an anatomical variant of the left subclavian vein draining via the jugular veins, with compression of both subclavian veins between the clavicle and first rib when arms were elevated. Slower drainage on the left, due to smaller collateral vessels, explained her unilateral symptoms. She was diagnosed with venous thoracic outlet syndrome, a rare condition where positional compression impairs venous return through the costoclavicular space. Muscle tightness from desk posture likely narrowed the space further. She was treated conservatively with physical therapy. At 3-month follow-up, her symptoms resolved.

This case describes a 36-year-old woman who developed swelling and bluish discoloration of her left arm when raising it, triggered after prolonged desk work. CT showed no thrombosis. Venography revealed an anatomical variant of the left subclavian vein draining via the jugular veins, with compression of both subclavian veins between the clavicle and first rib when arms were elevated. Slower drainage on the left, due to smaller collateral vessels, explained her unilateral symptoms. She was diagnosed with venous thoracic outlet syndrome, a rare condition where positional compression impairs venous return through the costoclavicular space. Muscle tightness from desk posture likely narrowed the space further. She was treated conservatively with physical therapy. At 3-month follow-up, her symptoms resolved.