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Frequently Asked Questions
| Treatment of Acute Axillary-Subclavian Venous Thrombosis |
| Q: I was building my weightlifting repetitions over the weekend and woke up with a swollen and painful right arm. It has not resolved with rest; what should I do?
A: You may have a case of effort vein thrombosis of the right arm. Due to trauma to the subclavian vein as a result of the first rib and clavicle rubbing together abnormally, your vein has developed a blood clot within it. You should seek medical attention.
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| Q: What are the risks of ignoring the symptoms of effort vein thrombosis?
A: As with any deep vein thrombosis, local symptoms (swelling, pain especially with exercise) may not resolve sufficiently to allow unrestricted use of the arm and, in addition, a pulmonary embolus (blood clot traveling to the lungs) may occur.
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| Q: What is needed to confirm that I do or do not have a clot in my upper arm and shoulder veins?
A: The diagnosis of deep vein thrombosis within the axillary and/or subclavian vein is made by duplex study (ultrasound study) and may be further confirmed by the use of contrast injected into the vein (a venogram).
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| Q: What needs to be done to minimize the problems that can be associated with upper arm deep vein thrombosis?
A: The use of anticoagulation can minimize the risk of a pulmonary embolus (a blood clot traveling into the lung). It will also help to relieve some of the congestion in the arm veins (thereby decreasing swelling) by preventing more clot from forming and by giving the body time to open other smaller veins to move the blood out of the arm. This may not be sufficient treatment for someone who must use the affected arm in a vigorous manner.
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| Q: I am an active construction worker and have just experienced a clot of my right arm deep shoulder veins. If simple anticoagulation may not provide me with full arm function within a short period of time, what might be needed?
A: One might need to consider dissolving the clot immediately (by means of thrombolysis), and then removing any mechanical compression (a first rib resection or removal of the clavicle) if that appears to be the cause of the clotting in the first place. Chronic trauma to the vein by the mechanical compression may have resulting in scarring of its opening, and, in this case, the vein opening may have to be repaired as well.
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