Disease of physically active people. Why does subclavian vein thrombosis develop?

Each disease has its own age limits. Some diseases develop mainly in the elderly, others appear in young people. To the "young" diseases include thrombosis of the subclavian vein. This condition appears more often in men aged 25-35 years, and it is associated with greater physical stress on the hands.

Most cases of subclavian vein thrombosis were unilateral. Moreover, that limb is affected, which is more susceptible to physical exertion, in right-handed people the right hand is affected, in left-handers - the left hand. What are the causes and symptoms of subclavian vein thrombosis, read in our article.

Causes of subclavian vein thrombosis

The thrombosis of the subclavian vein quite rarely appears from the action of an embolus in the form of a blood clot that has formed in another part of the body. The cessation of blood flow from an embolus is more typical for the veins of the lower extremities, which is due to the peculiarities of the systemic blood flow.

In the initial stages, thrombosis of the subclavian vein may be completely invisible, because the blockage of the vessel occurs slowly, and the collateral circulation has time to form. The cause of thrombosis is physical overexertion of the arm.

The main factors in the development of subclavian vein thrombosis:

• Deceleration of local blood flow.
• Aseptic phlebitis of the subclavian vein.
• Disorders of the blood coagulation process (with genetically determined diseases or excessive synthesis of blood coagulation factors).
• Compression of the veins of the arm in case of fractures of the clavicle, an atypical additional cervical rib.
• Uncomfortable posture during sleep, which is accompanied by impaired blood flow in the veins of the upper limbs.
• Frequently wearing uncomfortable clothing that constricts the hand.

Clinical manifestations of subclavian vein thrombosis

The main diagnostic criterion for subclavian vein thrombosis is the development of symptoms after exercise. Symptoms appear as the severity of hypertension in the veins, after which they reverse.

Thrombosis of the subclavian vein is manifested by the development of edema of the entire arm and pain in it. There is an increase in the venous pattern on the affected arm. When you press the edema, there is no dent left, the edema is dense and tense.  The pain is throbbing or bursting, localized along the veins and is intermittent. Subclavian vein thrombosis pain can radiate to the collarbone, shoulder joint, upper chest, and back.

Neurological symptoms are often observed in the affected arm – burning or tingling sensation in the hand, limited range of motion, increased tendon reflexes, atrophic changes in the muscles of the hand. Thrombosis of the subclavian vein in the chronic stage has more pronounced neurological symptoms. With a compensatory increase in collateral circulation, the edema and the severity of the venous pattern periodically decrease.

The development of acute thrombosis of the subclavian vein can be suspected if there is pain in the arm after physical exertion, weakness in one arm, pain and swelling of the arm after sleep, and rapid fatigue of the limb during any work.

What is the treatment for subclavian vein thrombosis?

To clarify the diagnosis of subclavian vein thrombosis, X-ray or MRI of the shoulder girdle is performed to determine the cause of the thrombus. Contrast X-ray or Doppler examination is used to assess the flow in the affected vein, obtaining a two- or three-dimensional image.

Treatment of subclavian vein thrombosis is to fix the existing thrombus and prevent its re-formation. The main goal is to restore disturbed blood flow. This is achieved by the use of such drugs:

• Means for dissolving a blood clot – thrombolytic drugs, heparin and its derivatives.
• Flavonoids are prescribed to relieve pain, reduce inflammation and improve the metabolism of the vascular wall.
• Local compresses with alcohol, troxevasin ointment are used to relieve pain and swelling.

In case of ineffectiveness of conservative therapy, with persistent disturbance of blood flow in venous and arterial vessels, which poses a threat of gangrene of the upper limb, an operative method of treatment of thrombosis of the subclavian vein is used. During the surgical intervention, a thrombus and necrotic areas of the affected limb are removed.