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Hollabaugh WL, Bowman EN. Effort-Associated Thrombosis: Imaging Is Key when Suspicion Is High. A Case Report. Curr Sports Med Rep 2022; 21:395-397. [PMID: 36342393 DOI: 10.1249/jsr.0000000000001007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- William L Hollabaugh
- Division of Sports Medicine, Department of Orthopaedic Surgery, Vanderbilt University Medical Center, Nashville, TN
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Hull JH, Burns P, Carre J, Haines J, Hepworth C, Holmes S, Jones N, MacKenzie A, Paton JY, Ricketts WM, Howard LS. BTS clinical statement for the assessment and management of respiratory problems in athletic individuals. Thorax 2022; 77:540-551. [DOI: 10.1136/thoraxjnl-2021-217904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Brennan FH. Diagnosis, Management of, and Return to Play Guidance for Venous Thromboembolism in Athletes. Curr Sports Med Rep 2022; 21:129-136. [PMID: 35394954 DOI: 10.1249/jsr.0000000000000949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
ABSTRACT Venous thromboembolism (VTE) is not rare and is becoming more recognized in our athletic population. This diagnosis can be elusive. A provider must have a high clinical suspicion and use pretest probabilities to order the appropriate studies and accurately diagnose a VTE. Treatment using direct oral anticoagulants for 3 months is recommended in most cases. Gradual return to play can be achieved after treatment is complete. Some athletes, however, may require lifelong anticoagulation. Return to collision sports may be possible using a timed dose strategy if long-term anticoagulation is needed. The management of an athlete with a VTE should include an individualized treatment plan and involve shared decision making with the athlete, team physicians, and hematologic specialists.
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Affiliation(s)
- Fred H Brennan
- BayCare Family Medicine Residency and Sports Medicine, University of South Florida, Morton Plant; Department of Family Medicine, University of South Florida Morsani College of Medicine; and Tampa Bay Buccaneers, Tampa, FL
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Nelson DA, Deuster PA, O'Connor FG, Edgeworth DB, Kurina LM. An investigation of sickle cell trait, body mass index, and fitness in relation to venous thromboembolism among African American adults. J Thromb Haemost 2021; 19:2216-2224. [PMID: 34105875 DOI: 10.1111/jth.15422] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 05/26/2021] [Accepted: 06/01/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND The relationships of sickle cell trait (SCT), body mass index (BMI), and physical fitness to venous thromboembolism (VTE) in young adults have received little attention. OBJECTIVES To test for associations among SCT, BMI, fitness, and VTE. PATIENTS/METHODS We conducted a retrospective cohort study of 48,316 SCT-tested, African American individuals in the US Army during 2011-14. We used Cox proportional hazards models to compute adjusted hazards of deep vein thrombosis (DVT) and pulmonary embolism (PE) associated with selected factors. RESULTS Incidence rates of DVT and PE were 1.09 and 0.91 cases per 1000 person-years, respectively. Adjusted hazard ratios (aHRs) for DVT for men and women with SCT were 0.9 (95% confidence interval [CI]: 0.4-2.0; P = .711) and 1.51 (CI: 0.7-3.2; P = .274), respectively. aHRs for PE for SCT+ men and women were 1.1 (CI: 0.5-2.4; P = .773) and 1.2 (CI: 0.5-3.1; P = .650), respectively. Low physical fitness was associated with DVT and PE in women (DVT aHR =3.1; CI: 1.4-6.5; P = .004; PE aHR =4.6; CI: 2.1-9.9; P < .001) and DVT in men (aHR =2.2; CI: 1.0-4.6; P = .048). Recent weight gain of 1 or more BMI points was associated with DVT in men (aHR =1.8; CI: 1.1-2.8; P = .017). CONCLUSIONS We found no evidence of increased VTE risk associated with SCT in this population. However, lower fitness levels and BMI increases were so associated.
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Affiliation(s)
- D Alan Nelson
- Consortium for Health and Military Performance, Department of Military and Emergency Medicine, Uniformed Services University, Bethesda, Maryland, USA
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, Maryland, USA
- Department of Medicine, Division of Primary Care and Population Health, Stanford University School of Medicine, Stanford, California, USA
| | - Patricia A Deuster
- Consortium for Health and Military Performance, Department of Military and Emergency Medicine, Uniformed Services University, Bethesda, Maryland, USA
| | - Francis G O'Connor
- Consortium for Health and Military Performance, Department of Military and Emergency Medicine, Uniformed Services University, Bethesda, Maryland, USA
| | - Daniel B Edgeworth
- Consortium for Health and Military Performance, Department of Military and Emergency Medicine, Uniformed Services University, Bethesda, Maryland, USA
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, Maryland, USA
| | - Lianne M Kurina
- Department of Medicine, Division of Primary Care and Population Health, Stanford University School of Medicine, Stanford, California, USA
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Devilbiss Z, O'Connor F. Pulmonary Embolism in a Collegiate Softball Athlete: A Case Report. Curr Sports Med Rep 2020; 19:53-57. [PMID: 32028349 DOI: 10.1249/jsr.0000000000000682] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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Romano S, Salustri E, Robles AG, Calò L, Penco M, Sciarra L. Non-vitamin K antagonist oral anticoagulants and sport. Minerva Cardioangiol 2020; 68:98-109. [PMID: 32429628 DOI: 10.23736/s0026-4725.20.05177-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Physical activity is worldwide recommended for its benefits on cardiovascular system. There is an increasing number of people of all ages that approach sport activity both as leisure time physical activity and as competitive sport. It is always more frequent the request even from older subjects and cardiac patients to be allowed to practice physical activity. Some problems could arise when these subjects present or develop pathologic conditions that require specific pharmacological treatment, in particular an anticoagulation therapy. This review focalizes on the management of oral anticoagulant therapy (OAT) in patients practicing sport activity, especially due to atrial fibrillation and deep vein thrombosis, which represent two highly prevalent conditions, particularly with increasing age. Official recommendations in this field may appear limiting for patients, forbidding in the majority of cases sports at risk of trauma and consequent bleeding. These recommendations still resent the heritage of the "traditional" management of OAT, mainly represented by vitamin-K antagonists (VKAs). The non-vitamin K antagonist oral anticoagulants, with their more favorable pharmacokinetic-pharmacodynamic profile compare to VKAs, may now represent an opportunity to modify the approach to sport activity in patients with an indication to OAT. This review of the literature deals with possible strategies to overcome the present limitations for OAT subjects willing to pursue a healthy lifestyle, that include sport activity, minimizing at the same time their risk of bleeding.
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Affiliation(s)
- Silvio Romano
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | - Elisa Salustri
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy -
| | - Antonio G Robles
- Department of Cardiology, Casilino Polyclinic Hospital, Rome, Italy
| | - Leonardo Calò
- Department of Cardiology, Casilino Polyclinic Hospital, Rome, Italy
| | - Maria Penco
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | - Luigi Sciarra
- Department of Cardiology, Casilino Polyclinic Hospital, Rome, Italy
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Treatment of venous thromboembolism in pediatric patients. Blood 2020; 135:335-343. [DOI: 10.1182/blood.2019001847] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Accepted: 12/16/2019] [Indexed: 12/29/2022] Open
Abstract
Abstract
Venous thromboembolism (VTE) is rare in healthy children, but is an increasing problem in children with underlying medical conditions. Pediatric VTE encompasses a highly heterogenous population, with variation in age, thrombosis location, and underlying medical comorbidities. Evidence from pediatric clinical trials to guide treatment of VTE is lacking so treatment is often extrapolated from adult trials and expert consensus opinion. Aspects unique to children include developmental hemostasis and the major role of central venous access devices. There is an absence of information regarding the optimal target levels of anticoagulation for neonates and infants and lack of suitable drug formulations. Anticoagulants, primarily low-molecular-weight heparin and warfarin, are used to treat children with symptomatic VTE. These drugs have significant limitations, including the need for subcutaneous injections and frequent monitoring. Randomized clinical trials of direct oral anticoagulants in pediatric VTE are ongoing, with results anticipated soon. These trials will provide new evidence and options for therapy that have the potential to improve care. International collaborative registries offer the ability to study outcomes of rare subgroups of pediatric VTE (eg, renal vein thrombosis), and will be important to ultimately guide therapy in a more disease-specific manner.
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Clyde T, Gordon C. Athletes with Clotting and Bleeding Disorders. Curr Sports Med Rep 2019; 18:427-428. [PMID: 31834170 DOI: 10.1249/jsr.0000000000000656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Broatch JR, Bishop DJ, Zadow EK, Halson S. Effects of Sports Compression Socks on Performance, Physiological, and Hematological Alterations After Long-Haul Air Travel in Elite Female Volleyballers. J Strength Cond Res 2019; 33:492-501. [PMID: 30531419 DOI: 10.1519/jsc.0000000000003002] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Broatch, JR, Bishop, DJ, Zadow, EK, and Halson, S. Effects of sports compression socks on performance, physiological, and hematological alterations after long-haul air travel in elite female volleyballers. J Strength Cond Res 33(2): 492-501, 2019-The purpose of this investigation was to assess the merit of sports compression socks in minimizing travel-induced performance, physiological, and hematological alterations in elite female volleyball athletes. Twelve elite female volleyballers (age, 25 ± 2 years) traveled from Canberra (Australia) to Manila (Philippines), and were assigned to 1 of 2 conditions; compression socks (COMP, n = 6) worn during travel or a passive control (CON, n = 6). Dependent measures included countermovement jump (CMJ) performance, subjective ratings of well-being, cardiovascular function, calf girth, and markers of blood clotting, collected before (-24 hours, CMJ; -12 hours, all measures), during (+6.5 and +9 hours, subjective ratings and cardiovascular function), and after (+12 hours, all measures except CMJ; +24 hours and +48 hours, CMJ) travel. When compared with CON, small-to-large effects were observed for COMP to improve heart rate (+9 hours), oxygen saturation (+6.5 hours and +9 hours), alertness (+6.5 hours), fatigue (+6.5 hours), muscle soreness (+6.5 hours and +9 hours), and overall health (+6.5 hours) during travel. After travel, small-to-moderate effects were observed for COMP to improve systolic blood pressure (+12 hours), right calf girth (+12 hours), CMJ height (+24 hours), mean velocity (+24 hours), and relative power (+48 hours), compared with CON. COMP had no effect on the markers of blood clotting. This study suggests that compression socks are beneficial in combating the stressors imposed by long-haul travel in elite athletes, and may have merit for individuals frequenting long-haul travel or competing soon after flying.
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Affiliation(s)
- James R Broatch
- Institute for Health and Sport (IHES), Victoria University, Melbourne, Victoria, Australia.,Department of Physiology, Australia Institute of Sport, Belconnen, Australian Capital Territory, Australia
| | - David J Bishop
- Institute for Health and Sport (IHES), Victoria University, Melbourne, Victoria, Australia.,School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
| | - Emma K Zadow
- Sports Performance Optimization Research Team, School of Health Sciences, University of Tasmania, Launceston, Tasmania, Australia
| | - Shona Halson
- Department of Physiology, Australia Institute of Sport, Belconnen, Australian Capital Territory, Australia.,School of Behavioral and Health Sciences, Australian Catholic University, Melbourne, Victoria, Australia
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Overview of venous pathology related to repetitive vascular trauma in athletes. J Vasc Surg Venous Lymphat Disord 2019; 7:756-762. [PMID: 31231058 DOI: 10.1016/j.jvsv.2019.03.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Accepted: 03/29/2019] [Indexed: 11/21/2022]
Abstract
BACKGROUND Athletes are generally young, high-functioning individuals. Pathology in this cohort is associated with a decrease in function and consequently has major implications on quality of life. Venous disorders can be attributed to a combination of vascular compression with a high burden of activity. OBJECTIVE This article promotes increased awareness of these uncommon conditions specific to the athlete by summarizing pathophysiology, clinical features, investigation, and treatment protocols for use in clinical practice. Prognostic outcomes of these management regimens are also discussed, allowing for clinicians to counsel these high-functioning individuals appropriately. With the aim of providing an overview of sport-related venous pathology, a literature review was undertaken identifying articles that were independently reviewed by the authors. RESULTS Lower limb venous thrombosis has been identified in young, high-functioning athletes attributed to both compression-related venous trauma, associated with repetitive movements resulting in intimal damage, and blunt trauma. The diagnosis and treatment follow the same protocols as for the general population. Of note, early ambulation is advocated, with an aim to return to premorbid (noncontact) function within 6 weeks. Athletes performing high-intensity repetitive upper limb movement, such as baseball players, are predisposed to upper limb deep venous thrombosis (DVT). Diagnosis follows the same protocols as for lower extremity DVT; however, the optimal treatment strategy remains debated. Current guidelines advocate the use of anticoagulation alone. A specific subset of primary upper limb DVT is effort thrombosis, where there is compression at the level of the thoracic outlet. Thrombolysis with first rib resection is indicated in the acute setting within 14 days. In cases of complete occlusion, surgical decompression with venous reconstruction may be required. Popliteal vein entrapment syndrome is also discussed. This entity has been identified as an overuse injury associated with popliteal vein compression. Duplex ultrasound examination is indicated as a first-line investigation, with conservative noninvasive options considered as an initial management strategy. Chronic venous insufficiency or persistent symptoms may require subsequent surgical decompression. CONCLUSIONS Key conditions including upper extremity and lower extremity venous thrombosis, venous aneurysms, Paget-Schroetter syndrome (effort thrombosis), and popliteal vein entrapment syndrome are discussed. Further studies evaluating long-term outcomes on morbidity for current treatment regimens in upper extremity DVT, effort thrombosis, venous thoracic outlet syndrome, and popliteal venous entrapment syndrome are required.
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12
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Witmer CM. How I approach managing student athletes at risk for bleeding. Pediatr Blood Cancer 2019; 66:e27523. [PMID: 30362247 DOI: 10.1002/pbc.27523] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Revised: 10/04/2018] [Accepted: 10/04/2018] [Indexed: 01/19/2023]
Abstract
Frequently, pediatric hematologists need to provide guidance regarding sports participation for children with congenital coagulopathies, immune thrombocytopenia, and those receiving anticoagulation. Although sports participation has clear health and psychosocial benefits, it can be associated with harm secondary to bleeding from injury. Decision-making for sports involvement should be individualized, patient centered, and well informed. This review focuses on the current data regarding the benefit as well as risks for sports participation and provides a framework for advising and supporting the student athlete who is at risk for bleeding.
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Affiliation(s)
- Char M Witmer
- The Children's Hospital of Philadelphia, Division of Hematology, Philadelphia, Pennsylvania
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Moll S, Berkowitz JN, Miars CW. Elite athletes and anticoagulant therapy: an intermittent dosing strategy. HEMATOLOGY. AMERICAN SOCIETY OF HEMATOLOGY. EDUCATION PROGRAM 2018; 2018:412-417. [PMID: 30504340 PMCID: PMC6246004 DOI: 10.1182/asheducation-2018.1.412] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Traditionally, the athlete who requires long-term anticoagulation has been told to forgo participation in contact and collision sports. However, a strategy of short-term interruption of anticoagulant therapy may be designed for some athletes, allowing them return to full athletic activity. A personalized pharmacokinetic/pharmacodynamic study of a direct oral anticoagulant (DOAC) may allow athletic participation when plasma drug concentration is minimal and resumption of treatment after the risk of bleeding sufficiently normalizes. Scientific data and uncertainties regarding this approach, as well as practical challenges in the implementation, will be discussed.
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Affiliation(s)
- Stephan Moll
- Hemophilia and Thrombosis Center, Division of Hematology-Oncology, Department of Medicine
| | - Joshua N. Berkowitz
- Department of Orthopaedics, and
- Department of Sports Medicine, School of Medicine, University of North Carolina, Chapel Hill, NC
| | - Christopher W. Miars
- Primary Care Sports Medicine, Baylor Scott & White Health, Waco, TX; and
- Baylor University Athletics, Waco TX
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Bishop M, Astolfi M, Padegimas E, DeLuca P, Hammoud S. Venous Thromboembolism Within Professional American Sport Leagues. Orthop J Sports Med 2017; 5:2325967117745530. [PMID: 29318176 PMCID: PMC5753956 DOI: 10.1177/2325967117745530] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background Numerous reports have described players in professional American sports leagues who have been sidelined with a deep vein thrombosis (DVT) or a pulmonary embolism (PE), but little is known about the clinical implications of these events in professional athletes. Purpose To conduct a retrospective review of injury reports from the National Hockey League (NHL), Major League Baseball (MLB), the National Basketball Association (NBA), and the National Football League (NFL) to take a closer look at the incidence of DVT/PE, current treatment approaches, and estimated time to return to play in professional athletes. Study Design Descriptive epidemiology study. Methods An online search of all team injury and media reports of DVT/PE in NHL, MLB, NBA, and NFL players available for public record was conducted by use of Google, PubMed, and SPORTDiscus. Searches were conducted using the professional team name combined with blood clot, pulmonary embolism, and deep vein thrombosis. Results A total of 55 venous thromboembolism (VTE) events were identified from 1999 through 2016 (NHL, n = 22; MLB, n = 16; NFL, n = 12; NBA, n = 5). Nineteen athletes were reported to have an upper extremity DVT, 15 had a lower extremity DVT, 15 had a PE, and 6 had DVT with PE. Six athletes sustained more than 1 VTE. The mean age at time of VTE was 29.3 years (range, 19-42 years). Mean (±SD) time lost from play was 6.7 ± 4.9 months (range, 3 days to career end). Seven athletes did not return to play. Players with upper extremity DVT had a faster return to play (mean ± SD, 4.3 ± 2.7 months) than those with lower extremity DVT (5.9 ± 3.8 months), PE (10.8 ± 6.8 months), or DVT with PE (8.2 ± 2.6 months) (F = 5.69, P = .002). No significant difference was found regarding time of return to play between sports. Conclusion VTE in professional athletes led to an average of 6.7 months lost from play. The majority of athletes were able to return to play after a period of anticoagulation or surgery. Those with an upper extremity DVT returned to play faster than those with other types of VTE. Further study is needed to look into modifiable risk factors for these events and to establish treatment and return-to-play guidelines to ensure the safety of these athletes.
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Affiliation(s)
- Meghan Bishop
- Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA
| | - Matthew Astolfi
- Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA
| | - Eric Padegimas
- Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA
| | - Peter DeLuca
- The Rothman Institute, Philadelphia, Pennsylvania, USA
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Berkowitz JN, Moll S. Athletes and blood clots: individualized, intermittent anticoagulation management. J Thromb Haemost 2017; 15:1051-1054. [PMID: 28301715 DOI: 10.1111/jth.13676] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2016] [Indexed: 11/30/2022]
Abstract
Essentials Athletes on anticoagulants are typically prohibited from participation in contact sports. Short-acting anticoagulants allow for reconsideration of this precedent. An individualized pharmacokinetic/pharmacodynamics study can aid patient-specific management. Many challenges and unresolved issues exist regarding such tailored intermittent dosing. SUMMARY Athletes with venous thromboembolism (VTE) are typically prohibited from participating in contact sports during anticoagulation therapy, but such mandatory removal from competition can cause psychological and financial detriments for athletes and overlooks patient autonomy. The precedent of compulsory removal developed when options for anticoagulation therapy were more limited, but medical advances now allow for rethinking of the management of athletes with VTE. We propose a novel therapeutic approach to the treatment of athletes who participate in contact sports and require anticoagulation. A personalized pharmacokinetic/pharmacodynamics study of a direct oral anticoagulant can be performed for an athlete, which can inform the timing of medication dosing. Managed carefully, this can allow athletic participation when plasma drug concentration is minimal (minimizing bleeding risk) and prompt resumption of treatment after the risk of bleeding sufficiently normalizes (maximizing therapeutic time).
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Affiliation(s)
- J N Berkowitz
- Departments of Orthopaedics and Sports Medicine, University of North Carolina School of Medicine, Chapel Hill, NC, USA
| | - S Moll
- Department of Medicine, Division of Hematology-Oncology, Hemophilia and Thrombosis Center, University of North Carolina School of Medicine, Chapel Hill, NC, USA
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Hull CM, Hopkins CL, Purdy NJ, Lloyd RC, Harris JA. A case of unprovoked venous thromboembolism in a marathon athlete presenting atypical sequelae: What are the chances? Scand J Med Sci Sports 2014; 25:699-705. [DOI: 10.1111/sms.12262] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/01/2014] [Indexed: 01/18/2023]
Affiliation(s)
- C. M. Hull
- Institute of Life Science 1; College of Medicine; Swansea University; Swansea UK
| | - C. L. Hopkins
- Penmaen Residence; University Health Centre; Swansea UK
| | - N. J. Purdy
- Institute of Life Science 1; College of Medicine; Swansea University; Swansea UK
| | - R. C. Lloyd
- Penmaen Residence; University Health Centre; Swansea UK
| | - J. A. Harris
- Penmaen Residence; University Health Centre; Swansea UK
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Jackson SS, O'Brien MJ. Case report: upper extremity deep venous thrombosis in a 19-year-old baseball player. PHYSICIAN SPORTSMED 2014; 42:163-7. [PMID: 25244713 DOI: 10.3810/psm.2014.05.2068] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
This report describes a case of a collegiate baseball player who presented with 3 weeks of worsening right shoulder pain and mild swelling and faint discoloration of the right arm and hand. He was found to have a nonocclusive clot on his brachial vein and was treated with anticoagulants. This was his second lifetime thrombosis. A hematologic workup revealed no evidence of a hereditary origin, and thrombosis was believed to be related to recent exertion (baseball throwing). Upper extremity deep vein thromboses are extremely uncommon. However, because they can have potentially life-threatening consequences, deep vein thromboses must be on the differential for any athlete who presents with increased pain, swelling, or discoloration of an extremity.
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Affiliation(s)
- Sarah S. Jackson
- Department of Pediatrics, Massachusetts General Hospital, Boston, MA
| | - Michael J. O'Brien
- Division of Sports Medicine, Boston Children's Hospital, Boston MA
- The Micheli Center for Sports Injury Prevention, Waltham, MA
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Hypothenar Hammer Syndrome From Ice Hockey Stick-Handling. Ann Vasc Surg 2013; 27:1183.e5-10. [DOI: 10.1016/j.avsg.2013.01.014] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2012] [Accepted: 01/28/2013] [Indexed: 11/22/2022]
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Participation of Iatrogenically Coagulopathic Patients in Wilderness Activities. Wilderness Environ Med 2013; 24:257-66. [DOI: 10.1016/j.wem.2012.12.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2012] [Revised: 10/20/2012] [Accepted: 12/17/2012] [Indexed: 01/02/2023]
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Rajasekaran S, Kvinlaug K, Finnoff JT. Exertional Leg Pain in the Athlete. PM R 2012; 4:985-1000. [DOI: 10.1016/j.pmrj.2012.10.002] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2012] [Revised: 10/03/2012] [Accepted: 10/05/2012] [Indexed: 01/27/2023]
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