First Reported Case of Chest Varicosities Prior to Permanent Pacemaker Implantation

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.