Paget-Schroetter Syndrome in the Young and Active

Vijaysadan, Viju; Zimmerman, Aphrodite; Pajaro, Rafael E.

doi:10.3122/jabfm.18.4.314

Cited by 41 publications

(27 citation statements)

References 26 publications

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“…It is highly recommended for physicians to be familiar with the signs and symptoms of Paget-Schroetter syndrome, to ensure a quick and correct diagnosis, and to instantly afford the athlete proper therapy, as serious complications such as pulmonary embolism (PE) are present in up to one-third of patients with UEDVT 2 4 9…”

Section: Discussionmentioning

confidence: 99%

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Rock climbing-related subclavian vein thrombosis

2015

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Paget-Schroetter syndrome, also known as upper extremity deep venous thrombosis (UEDVT), is a rare condition, characterised by a (sub-) total occlusion of the axillary-subclavian venous system due to thrombosis. UEDVT is the most common vascular condition among athletes so far; although the general incidence is low, this problem will become more frequent as a result of increased participation in climbing sports. The purpose of this report is to illustrate two cases in rock climbers where UEDVT developed during rock climbing or bouldering. Fortunately, both patients were diagnosed relatively early after the symptoms began, despite the ambiguity of UEDVT symptoms. This relatively unfamiliar condition may become more highly recognised as a potentially serious differential diagnosis of unspecific pain of the shoulder. Rock climbers are disposed to develop UEDVT due to frequent stress on the upper extremities during training or competition.

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Section: Discussionmentioning

confidence: 99%

“…6 The vessel occluded in this area with the arm raised 4. Owing to this patient's unimproved symptoms, she finally received surgical therapy with first rib resection.…”

Section: Outcome and Follow-upmentioning

confidence: 97%

Rock climbing-related subclavian vein thrombosis

2015

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“…In our patient, warfarin sodium was discontinued after 11 weeks of therapy, although recent reports recommend at least 3-6 months of anticoagulation therapy for patients with DVT of an upper extremity. 9,10 Young patients with Paget-Schroetter syndrome are predisposed to the development of long-term consequences. According to one review, all 16 patients with Paget-Schroetter syndrome had residual swelling, and only 2 were asymptomatic during activity.…”

Section: Discussionmentioning

confidence: 99%

Push-Up Exercise Induced Thrombosis of the Subclavian Vein in a Young Woman: Report of a Case

2007

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Deep venous thrombosis (DVT) is common, but only 2%-4% of DVTs involve the upper extremities (Roos in Am J Surg 154:568-73, 1987). Upper extremity DVT has a primary or secondary cause, and primary thrombosis is much rarer than secondary thrombosis. Primary upper extremity DVT comprises effort venous thrombosis and idiopathic thrombosis. Effort subclavian venous thrombosis, also called Paget-Schroetter syndrome, is an uncommon entity, which usually develops after strenuous effort of the upper extremities. Effort thrombosis of the upper extremity has been described in athletes involved in a wide variety of sports, including ball games, combatant sport and heavy athletics, games with rackets or clubs, and aquatic sports (Zell et al. in Angiology 52:337-42, 2001). Push-up exercise is a strengthening exercise for building up strength and endurance in the muscles of the upper arm and shoulders. It is also considered to be a core exercise in shoulder rehabilitation programs to activate the serratus anterior muscle in people with shoulder dysfunction (Ludewig et al. in J Sports Med 32:484-93, 2004). We report what to our knowledge is the first case of effort DVT of an upper extremity caused by push-up exercise.

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“…9 Aggressive treatment, such as thrombolysis and surgical decompression, is thought to be most effective for the prevention of longterm problems in young and active patients. 6,24 Judicious thrombolysis followed by a course of anticoagulation has also been advocated, with surgical decompression reserved for refractory conditions. 22 In cases of external compression, such as an element of thoracic outlet syndrome or clavicular impingement, acute correction of the anatomy would be advocated by most vascular surgeons.…”

Section: Clinical Diagnosismentioning

confidence: 99%

Unique Treatment Regimen for Effort Thrombosis in the Nondominant Extremity of an Overhead Athlete: A Case Report

Snead

Marberry

Rowdon

2009

Journal of Athletic Training

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Objective: To advise athletic trainers on the potential for effort thrombosis to occur in nonthrowing athletes and to underscore the importance of early recognition and treatment. Background: An 18-year-old offensive lineman presented with a 1-day history of diffuse shoulder pain with no specific history of injury; swelling and erythema involved the entire left upper extremity. He was immediately referred to the team physician, who suspected deep vein thrombosis and sent the athlete to an imaging center. Duplex ultrasound was obtained on the day of presentation, and he was admitted to the hospital that evening. Differential Diagnosis: Deep vein thrombosis, thoracic outlet syndrome, shoulder tendinitis. Treatment: Anticoagulation with heparin was administered at the hospital, and he was sent home the next day on subcutaneous enoxaparin sodium, followed by a 5-mg daily dose of oral warfarin sodium. Oral anticoagulants were continued for a total of 4 weeks. The athlete began upper body lifting and was released 5 weeks postinjury to gradually return to football without restrictions. Uniqueness: Effort thrombosis is typically seen in the dominant arm of athletes, and the current treatment protocol calls for thrombolysis or surgical intervention. This athlete, whose position required repeated elevation of his arms in forward flexion, sustained the injury in his nondominant arm, was treated with anticoagulation only, and had a full return to football. At 18-month follow-up, he had no recurrence of symptoms. Conclusions: Early recognition and treatment of athletes with effort thrombosis is paramount to a successful clinical outcome and prompt return to play.

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Paget-Schroetter Syndrome in the Young and Active

Cited by 41 publications

References 26 publications

Rock climbing-related subclavian vein thrombosis

Rock climbing-related subclavian vein thrombosis

Push-Up Exercise Induced Thrombosis of the Subclavian Vein in a Young Woman: Report of a Case

Unique Treatment Regimen for Effort Thrombosis in the Nondominant Extremity of an Overhead Athlete: A Case Report

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