Incidence of subclavian vein thrombosis detected during first-pass phase of radionuclide angiocardiogram.

A 79-yr-old woman with asymptomatic subclavian vein thrombosis associated with transvenous pacemaker electrode and congestive heart failure is reported. The subclavian thrombosis was discovered accidentally from the first-pass radionuclide angiogram that is routinely performed with the intravenous bolus injection of the radiopharmaceutical for a gated blood-pool study. It demonstrated venous obstruction at the level of the subclavian vein and abnormal collateral circulation over the chest wall consistent with subclavian thrombosis. This case report and literature review demonstrates the importance of performing first-pass radionuclide cardioangiography routinely before multigated blood-pool studies in patients with pacemakers.