Question
Not long after my ICD was implanted, I noticed that my left arm looked bigger than my right arm but I was more concerned about finding out if I was still at risk of mortality. No one asked me about the arm swelling and I just figured it was a weird anomaly. Then my arm swelled even more after I started backpacking and my wrist kind of hurt sometimes and my hand became purple colored. My regular doctor couldn't figure it out but a specialist doctor said it was Thoracic Outlet Syndrome. My question is - How common is Thoracic Outlet Syndrome in ICD patients and is there any way that it can be lessened or cured?
Answer
Occasionally, some patients may experience reduced blood flow or even a blockage in the blood vessel where the ICD lead(s) reside. This can result in swelling and/or discoloration of the upper arm or the entire arm on the same side where the ICD is implanted. This typically occurs within days or weeks following the implant and is diagnosed by an upper extremity "ultrasound" (a sound wave evaluation of the blood vessels in the arm). Treatment usually includes elevation of the affected arm and a daily blood thinner (warfarin) taken by mouth. Eventually the body develops new blood vessels to allow the blood to flow around the blockage and over time, the swelling resides. Thoracic Outlet Disorder is a completely different disorder and is defined as: A group of distinct disorders that affect the nerves in the brachial plexus (nerves that pass into the arms from the neck) and various nerves and blood vessels between the base of the neck and axilla (armpit). For the most part, these disorders have very little in common except the site of occurrence. The disorders are complex, somewhat confusing, and poorly defined, each with various signs and symptoms of the upper limb.
Source: http://www.ninds.nih.gov/disorders/thoracic/thoracic.htm
Obviously, any time you develop any new or concerning symptoms you should contact your physician to be evaluated.
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