"A patient with thoracic outlet syndrome and the link to severe tachycardia"

James Stoxen

Team Doctors Chiropractic Center, USA

DOI: 10.29011/2574-7754.C2.001

In this case report, we rendered a 60-year-old man with the diagnosis of arterial thoracic outlet syndrome. Patient had been
diagnosed with severe intermittent tachycardia.
When the patient received corticosteroid injections in the scalene muscles the heart rate went from 110 - 140 bpm to a sustained
60 - 70 bpm immediately and sustained until the effects of the corticosteroid injection wore off. This led the patient to believe
there was a direct connection between the thoracic outlet syndrome and the tachycardia.
During the examination the patient was tested with a pulse oximeter. When the patient protracted the shoulders the pulse oximeter
showed no pulse and shut off. This test was repeated three times and each time the result was the same.
In one study the authors proposed that the stellate ganglion or postganglionic efferent sympathetic fibers forming the cardiac
plexus are exposed to compression. We proposed this was also a possible cause of the rapid heart rate when the patient
protracted of the shoulders. Due to this irritation, there can be an increase in the cardiac sympathetic activity. Another possible
explanation is that there was a Low ejection fraction due to the blockage of blood flow in the arms.
After treating the patient with the integrated spring-mass approach the patients’ thoracic outlet syndrome and tachycardia
resolved simultaneously. We will review the possible etiology, examination and treatment protocols we used to reverse both the
tachycardia and the severe thoracic outlet syndrome.

James Stoxen, is the president of Team Doctors®, Chicago, Illinois, one of the most recognized treatment centers in the world. He has been invited to give scientific
presentations at over 60 medical conferences in Australia, Brazil, China, Columbia, France, Germany, India, Indonesia, Italy, Japan, Malaysia, Mexico, Monaco,
Portugal, Russia, South Africa, Thailand, UAE, UK England, UK Scotland, UK, and throughout the United States. In 2015, he was awarded an honorary fellowship
by a member of the royal family, the Sultan of Pahang, at the World Congress of Sports and Exercise Medicine for his distinguished research and contributions
to the advancement of sports and exercise medicine on an International level. In 2018 he published a book, Neck Pain? Back Pain? Shoulder Pain? Could it be
Thoracic Outlet Syndrome? which, became a #1 International Best Seller.
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