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First Reported Case of Chest Varicosities Prior to Permanent Pacemaker Implantation.

Daniel W Nelson¹, Timothy Sauld², Mohamed Djelmami-Hani^1,3

¹Aurora Cardiovascular and Thoracic Services, Aurora Sinai/Aurora St. Luke's Medical Centers, Milwaukee, Wisconsin, USA.

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|July 8, 2025

Summary

This summary is machine-generated.

Upper chest and shoulder varicosities indicate venous obstruction, necessitating contrast venography before cardiac device implantation. This case highlights isolated varicosities preceding pacemaker insertion.

Keywords:

cardiac device implantation chest and shoulder varicosities contrast venography venous obstruction

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Area of Science:

Vascular Medicine
Cardiology
Medical Imaging

Background:

Varicosities typically affect the lower extremities.
Upper extremity and chest varicosities are rare but significant indicators of venous obstruction.
Cardiac device implantation requires careful pre-procedural venous assessment.

Observation:

A patient presented with isolated left upper chest and shoulder varicosities.
These varicosities were noted prior to permanent pacemaker implantation.
This presentation is the first reported instance of such isolated findings.

Findings:

The presence of upper chest and shoulder varicosities suggests underlying venous obstruction.
Contrast venography is recommended to evaluate venous anatomy in these cases.
Prompt diagnosis is crucial for patient management.

Implications:

Early identification of venous obstruction is vital for patients undergoing cardiac device procedures.
Contrast venography should be considered in patients with unusual varicosity patterns.
This case underscores the importance of thorough venous evaluation in cardiology.