Improvement in Chest Pain Following Surgical Treatment for Thoracic Outlet Syndrome

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A 41-year-old woman with a 1-year history of right chest pain, with normal cardiology and pulmonology assessments. The chest pain was reproducible upon upper limb elevation. Computed tomography (CT) angiography in the arm-elevated position revealed subclavian artery and vein stenosis at the costoclavicular space, and the diagnosis was neurogenic thoracic outlet syndrome (TOS). Surgery involving endoscopic-assisted infraclavicular resection of the first rib and scalene muscles resulted in immediate postoperative symptom improvement. When chest pain persists after ruling out other conditions, neurogenic TOS should be considered in the differential diagnosis.