Primary Thrombophlebitis of the Left Subclavianvein*

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Only one case of primary thrombophlebitis of the subclavian vein has been found in the records of the Cleveland Clinic.

The patient, an athletic school-boy aged 18 years, sought medical advice because of pain in the left chest. He had been well until about seven weeks before the examination, when, during a game of basketball, he had begun to notice weakness, numbness and blueness of the left hand and arm which extended up to the shoulder. This condition progressed until the entire left upper extremity was swollen and blue, and the veins of the arm, shoulder and upper left portion of the chest “stood out like cords.” Examination by the family physician revealed that the blood pressure in the left arm was 30 mm. lower than that in the right arm. During the following two weeks all these symptoms had gradually subsided.

One week before his admission to the Clinic, or six weeks following the onset of the illness, the patient began to experience dull pain in the region of the left chest just below the nipple line. This pain was increased by deep breathing and was so severe at times that codeine was required for relief. The patient lost no weight, and he did not complain of cough, night sweats, fever or other symptoms referable to systemic disease.

The patient was a tall, asthenic youth whose weight was slightly below normal. His temperature was 98.6° F. and his pulse rate was 75. Except for the presence of some palpable. . .



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