Thoracic outlet syndrome (TOS) is a disorder that may compress the blood vessels or nerves in the upper chest region. This area — called the thoracic outlet — is behind and below the collarbone opposite the first rib.
At the UPMC Heart and Vascular Institute, we take a team approach to quickly and correctly diagnose your TOS. Then we'll create a treatment plan that's right for you.
To request an appointment, contact the UPMC Heart and Vascular Institute:
Thoracic outlet syndrome (TOS) is a group of disorders that puts pressure on the arteries, veins, or nerves in the upper chest.
TOS may cause symptoms in the:
There are three types of TOS. Symptoms help doctors determine the type of TOS you have.
In ATOS, an artery in the thoracic outlet compresses, narrows, or dilates.
An extra rib at the top of the rib cage or an abnormal first rib may cause this type of TOS.
Complications of ATOS can include:
In VTOS, a vein in the thoracic outlet becomes compressed and damaged. The most common cause is repetitive, strenuous shoulder and arm use.
Complications of VTOS can include:
In NTOS, the brachial plexus — the bundle of nerves in the thoracic outlet — compresses, often from:
NTOS complications can include:
Compressed blood vessels or nerves in the tight corridor of the thoracic outlet get irritated and can cause TOS.
Causes of compression may be:
TOS can occur on either side of the body but most often affects your dominant hand's side because of constant use.
Complications vary depending on the type of TOS you have.
A blood clot may break apart, and smaller pieces — called emboli — can move down the arm.
A blood clot can block blood flow to the hand, causing:
It's vital to restore blood flow to the hand quickly.
TOS happens to people of all ages and genders, but it is more common in young women.
Factors that can increase your risk of TOS include:
Our TOS experts
TOS most often causes symptoms in the upper body, such as the:
Symptoms vary based on the type of TOS.
Symptoms of ATOS include:
Symptoms of VTOS include:
Symptoms of NTOS include:
Make an appointment with your doctor if you have any signs or symptoms of TOS, and they don't go away.
To confirm a diagnosis of TOS, your team at the UPMC Heart and Vascular Institute will start by:
They also may order heart imaging and other tests, including:
Our TOS experts
Vascular surgeons at the UPMC Heart and Vascular Institute offer a range of treatments for arterial, venous, and neurogenic TOS.
Based on the type of TOS you have, we'll provide a course of treatment that meets your needs.
Your surgeon may operate to:
Your vascular surgeon may operate to:
Doctors may suggest surgery for those who fail to respond to physical therapy or medicine.
Your surgeon may:
Our TOS experts
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