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Arterial Thoracic Outlet Syndrome

Daniels, Brian MD1; Michaud, Leslie MD2; Sease, Franklin Jr MD1,3; Cassas, Kyle J. MD, FACSM3; Gray, Bruce H. DO4

doi: 10.1249/JSR.0000000000000034
Chest and Abdominal Conditions

Arterial thoracic outlet syndrome is a rare cause of shoulder pain due to compression of the subclavian or axillary artery within the thoracic outlet. It is the least common form of thoracic outlet syndrome but is potentially dangerous as it can result in significant morbidity. An athlete initially may present with exertional pain, early fatigability, a dull ache, or discomfort in the affected arm. History and physical examination are paramount in diagnosis, and imaging confirms the anatomy. Surgical repair or resection alleviates the compression of the affected structure and allows for a safe return to participation. Familiarity with this condition aids in the prompt diagnosis and treatment of this disorder.

1Steadman Hawkins Clinic of the Carolinas, Greenville Health Systems, Greenville, SC; 2Drisko, Fee, and Parkins, Independence, MO; 3University of South Carolina School of Medicine, Greenville, SC; and 4Vascular Health Alliance, Greenville Health Systems, Greenville, SC

Address for correspondence: Brian Daniels, MD, Steadman Hawkins Clinic of the Carolinas, Greenville Health Systems, 200 Patewood Drive, Suite C-100, Greenville, SC 29615-3593; E-mail:

Copyright © 2014 by the American College of Sports Medicine.