Thoracic Outlet Syndrome

 Heart & Vascular Care at EvergreenHealth, Kirkland WA
  

A thoracic outlet evaluation is used to detect compression of the blood vessels in the thoracic outlet, located in the shoulder region. Compression of the artery, vein or nerve that travel through the thoracic outlet can cause pain, numbness, weakness and swelling in the arm and/or hand, and can also increase the risk of blood clot or aneurysm.

The exam consists of an ultrasound to evaluate the arteries and veins in your shoulder region as well as a test that evaluates the arterial pulse in your finger while your arm is in different positions.  Ultrasound images are acquired using a hand held probe (transducer) that is applied to the neck and shoulder. 

Why is Thoracic Outlet evaluation performed?

This test is used to:

  • Evaluate the arteries and veins that pass through the thoracic outlet in the shoulder. 

Can I eat or drink on the day of the test?

Yes. Eat and drink as you normally would the day of the test (unless you are also scheduled that day for an ultrasound exam that requires fasting).


Should I take my medications the day of the test?

Take all of your medications at the usual times, as prescribed by your doctor.


What happens during the test?

  • A vascular sonographer will perform the thoracic outlet evaluation.
  • To monitor the arterial pulse in your arm, the sonographer will tape a small sensor to the index finger of your hand.  The sonographer will record arterial waveforms with your arm at rest and with your arm in different positions.  This will be done on both arms.
  • For the ultrasound exam, you may be asked to remove your shirt and wear a gown.  The ultrasound exam will start at the neck and extend along the shoulder on each side of the body.  The ultrasound transducer will have a small amount of gel on the end of it. The gel used during the exam is water-soluble and easily washes off with soap and water.

How will I feel during the test?

You may feel discomfort in your arms while they are held in different positions during this test. You should feel no significant discomfort during the ultrasound exam.


How long does the test take?

This exam usually takes about 45 minutes, depending on many variables. After the test, you may go home or go to your other scheduled appointments.


How do I get the results of my test?

After a vascular surgeon has interpreted your exam, the results will be sent to your referring physician and/or the vascular surgeon will go over the results with you during a follow-up appointment.