Related Experiment Video

Updated: Jun 5, 2026

Upper-extremity Approach for Secondary Access in Transfemoral Transcatheter Aortic Valve Implantation
06:04

Upper-extremity Approach for Secondary Access in Transfemoral Transcatheter Aortic Valve Implantation

Published on: August 8, 2025

Upper-extremity deep vein thrombosis and downhill esophageal varices caused by long-term pacemaker implantation

Nurcan Basar1, Kumral Cagli, Omer Basar

  • 1Department of Cardiology, Turkiye Yuksek Ihtisas Hospital, 06100, Ankara, Turkey. nurcanbasar@gmail.com

Texas Heart Institute Journal
|January 13, 2011
PubMed

Insights

Upper-extremity deep vein thrombosis (UEDVT) is common after cardiac device implantation. A rare case highlights UEDVT complicated by downhill esophageal varices, a life-threatening condition.

Area of Science:

  • Cardiology
  • Vascular Surgery
  • Gastroenterology

Background:

  • Upper-extremity deep vein thrombosis (UEDVT) frequently occurs post-pacemaker or cardioverter-defibrillator implantation.
  • Symptomatic presentation of UEDVT is infrequent, affecting only 1% to 3% of patients.

Observation:

  • A 54-year-old male patient with multiple cardiac pacemaker implants presented with bilateral UEDVT.
  • The patient developed downhill esophageal varices, a rare complication of superior vena cava obstruction, in the upper esophagus.

Findings:

  • The case presented a unique combination of severely symptomatic bilateral UEDVT and downhill esophageal varices.
  • This array of conditions, occurring together, is unprecedented in medical literature, with no reported bleeding from the varices.

Implications:

  • This case underscores the potential for severe complications arising from UEDVT following cardiac device implantation.
  • It highlights the critical need for vigilance in recognizing and managing rare but life-threatening conditions like downhill esophageal varices in affected patients.

Keywords:
Defibrillators, implantable/adverse effectsedema/epidemiology/etiologyesophageal and gastric varices/diagnosis/etiology/physiopathology/radiographypacemaker, artificial/adverse effectstomography, X-ray computedupper extremityvascular diseasesvena cava, superiorvenous thrombosis/diagnosis/etiology/therapy

More Related Videos

Catheter-based Endovascular Angioplasty for Fibrosing Mediastinitis-associated Pulmonary Vein Stenosis06:59

Catheter-based Endovascular Angioplasty for Fibrosing Mediastinitis-associated Pulmonary Vein Stenosis

Published on: August 26, 2025

Related Concept Videos

Esophageal Varices-I: Introduction01:24

Esophageal Varices-I: Introduction

Esophageal varices are dilated, tortuous veins which are found mainly in the submucosa of the lower esophagus but which may also appear higher up or extend into the stomach. They develop due to increased pressure in the portal venous system, often as a result of liver cirrhosis. This condition scars and damages the liver, impeding normal blood flow through the portal vein. To compensate, blood seeks alternative pathways, forming fragile new vessels (varices) in the esophagus and stomach. These...
Varicose Veins I: Introduction01:26

Varicose Veins I: Introduction

Varicose veins, or varicosities, are abnormally dilated and twisted superficial veins caused by venous valve incompetence. This condition commonly affects the lower extremities, especially the saphenous veins, due to the higher pressure from prolonged standing and walking. However, varicosities can also occur in other areas, such as the esophagus, vulva, spermatic cords, and anorectal region.Etiology and typesPrimary varicose veins, often idiopathic, are more common in women due to inherent...
Venous Thrombosis I: Introduction01:30

Venous Thrombosis I: Introduction

Venous thrombosis, the most common disorder of the veins, involves the formation of a thrombus or blood clot associated with vein inflammation. It can be classified as either superficial vein thrombosis or deep vein thrombosis.Superficial Vein Thrombosis: This involves the formation of a thrombus in a superficial vein, usually the greater or lesser saphenous vein. Though less severe than deep vein thrombosis (DVT), SVT can lead to complications if untreated.Deep Vein Thrombosis (DVT): This...
Pulmonary Embolism I: Introduction01:19

Pulmonary Embolism I: Introduction

A blood clot, or thrombus, is a semi-solid mass composed of fibrin, platelets, and red blood cells. When it forms within a vessel, it can obstruct blood flow, known as thrombosis. If part of the clot detaches, it becomes an embolus that can travel and block distant vessels. When this occurs in the pulmonary arteries, it causes a condition known as pulmonary embolism (PE).Origin and ImpactMost often, the embolus originates from a thrombus in the deep veins of the lower limbs, a condition called...
Pulmonary Embolism I: Introduction01:29

Pulmonary Embolism I: Introduction

Pulmonary embolism (PE) occurs when a thrombus, fat or air embolus, amniotic fluid, or tumor tissue blocks one or more pulmonary arteries. These blockages originate in the venous system or the right side of the heart.EtiologyPE primarily arises from deep vein thrombosis (DVT) and other hypercoagulable states, such as inherited thrombophilias. Additional etiological factors include venous stasis, commonly seen in obesity, and endothelial injury from surgery and trauma. Less common causes include...
Venous Thrombosis III: Interprofessional Care01:29

Venous Thrombosis III: Interprofessional Care

Venous thrombosis requires effective prevention and treatment strategies to improve patient outcomes and reduce potential complications.Prevention StrategiesHealthcare providers must prioritize preventing venous thromboembolism (VTE) for all adult patients upon admission. Interventions depend on bleeding and thrombosis risk, medical history, current medications, diagnoses, planned procedures, and patient preferences. Patients on bed rest should change positions every two hours and, if not...