Paget-Schroetter Syndrome Resulting from Thoracic Outlet Syndrome and KAATSU Training

Abstract

A 29-year-old woman who worked as a KAATSU (a type of body exercise that involves blood flow restriction) instructor visited our emergency room with a chief complaint of swelling and left upper limb pain. Chest computed tomography (CT) showed non-uniform contrast images corresponding to the site from the left axillary vein to the left subclavian vein; vascular ultrasonography of the upper limb revealed a thrombotic obstruction at the same site, leading to a diagnosis of Paget-Schroetter syndrome (PSS). We herein report our experience with a case of PSS derived from thoracic outlet syndrome (TOS), in a patient who was a KAATSU instructor.

Two Patients with Paget-Schroetter Syndrome That Were Successfully Diagnosed by Doppler Ultrasonography: Case Studies with a Literature Review

“…Vascular ultrasonography has a high diagnostic accuracy for PSS (4), however, it is not normally performed unless physicians consider PSS in the differential diagnosis. Fourteen patients first presented to an emergency department (9,13,17,20,21,(24)(25)(26)(27), which was the most frequent department visited in our research. Five patients were first seen at a primary care clinic (3,7,8).…”

“…Only one patient had a history of coagulopathy ( 6 ). The left and right upper arms were equally affected (right, 13 cases ( 5 - 15 ); left, 13 cases ( 16 - 27 ). In four patients, both sides were affected ( 20 , 28 - 30 ).…”

“…Only one patient had a history of coagulopathy (6). The left (16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27). In four patients, both sides were affected (20,(28)(29)(30).…”

“…Mostly, PSS affects young healthy males, and physicians might misdiagnose it as musculoskeletal disorders. Weightlifting was considered to be a risk factor in eight cited cases ( 6 , 15 , 20 , 21 , 23 , 25 , 27 , 29 ), and rock climbing, working as a waiter, and swimming were reported to be risk factors in two cases.…”

Paget-Schroetter Syndrome Secondary to Injury-Induced Thoracic Outlet Syndrome

“…It occurs most commonly in young individuals who are physically active and laborers with continued overuse of the upper extremities. 2 In this particular case, PSS resulted from injury-induced thoracic outlet syndrome (TOS).…”