Presentation
Patients who have chronic thrombosis will have significant collateral vessels and may present with engorgement of those vessels; however, this patient did not have those signs on presentation. [degruyter.com]
Clinical presentation includes complaints of blue, swollen, heavy, painful arm. [japi.org]
However, due to the mainly presentation in young athletic patients, the syndrome tends to be asymptomatic, or described by the patient as a simple muscular strain. [ejcvsmed.org]
Case Presentation We report a rare case of unusual left axillo-subclavian vein thrombosis in absence of clear risk factors and a negative hypercoagulable workup in a 36-year-old Hispanic woman who presented with 2 days duration of left upper extremity [thrombosisjournal.biomedcentral.com]
Hematological
- Easy Bruising
There was no history of chest pain, dyspnoea, cough, fever, bleeding, easy bruising and palpitation. There was no significant history of any past ailment. [japi.org]
Entire Body System
- Swelling
Significant improvement in the swelling of the affected limb was observed after a week of institution of anticoagulant therapy. [japi.org]
The tendency of the arm to swell soon subsides again. [de.zxc.wiki]
Abstract A 20-year-old male swimmer presented to the emergency department with right arm pain and swelling several days after a weight training session following swim team practice. [degruyter.com]
Full Text Case Report We describe a case of a 17-year-old male, Turkish basketball player, who presented to the clinic with one-week course of left upper limb pain with swelling and mild erythema. [ejcvsmed.org]
- Arm Pain
Herein, we report a 42-year-old male weightlifter who presented with swelling of the left arm, pain and a feeling of tightness in the anterior chest wall. [jocmr.org]
Abstract A 20-year-old male swimmer presented to the emergency department with right arm pain and swelling several days after a weight training session following swim team practice. [degruyter.com]
Patients present with symptoms and signs of an upper limb deep vein thrombosis (i.e. arm pain and swelling). Compression of the subclavian vein when it passes through the costoclavicular space is the most favored mechanism of thrombosis. [radiopaedia.org]
- Sepsis
Se la sepsi cavità orale è il fattore causale, anaerobi sono i più comuni. Microrganismi Gram-negativi, in particolare Proteus e Pseudomonas sono gli organismi più comuni nella sepsi otologica. [tanzariello.it]
- Turkish
Syndrome associated with thrombophilia Paget-von Schroetter Syndrome associated with thrombophilia Cengiz Bolcal, Kürşad Öz, Gökçe Şirin, Tankut Akay, Ufuk Demirkılıç Gülhane Askeri Tıp Akademisi Kalp ve Damar Cerrahisi Anabilim Dalı, Ankara Abstract Turkish [tgkdc.dergisi.org]
Full Text Case Report We describe a case of a 17-year-old male, Turkish basketball player, who presented to the clinic with one-week course of left upper limb pain with swelling and mild erythema. [ejcvsmed.org]
- Lymphedema
Condition management should include differential diagnosis such as cellulitis, lymphedema, neoplastic compression of veins, traumatic muscle injury, and thrombosis of superficial veins. [thrombosisjournal.biomedcentral.com]
Respiratoric
- Cough
There was no history of chest pain, dyspnoea, cough, fever, bleeding, easy bruising and palpitation. There was no significant history of any past ailment. [japi.org]
Cardiovascular
- Cyanosis
Symptoms may include sudden onset of pain, heat, redness, cyanosis and swelling of the arm. These thrombi rarely cause fatal pulmonary embolism. [emergency-live.com]
The clinical presentation typically consists of acute upper-extremity swelling, cyanosis, and pain. [appliedradiology.com]
[…] anatomic, and iatrogenic predisposing factors such as thrombophilia, thorasic outlet syndrome (TOS), and major vein catheterisation are typically underlying conditions.(10-13) Clinical features of PSS include sudden onset of pain, swelling, edema, and cyanosis [ejcvsmed.org]
Symptoms include sudden onset of pain, swelling, non-pitting oedema and cyanosis of the upper extremities. 2 Ouriel K Green M Google Scholar Collateral veins usually are visible around the shoulder and chest wall. [ejvesreports.com]
Other symptoms reported include heaviness, redness of arm, cyanosis and dilated, visible veins across the shoulder and upper arm (Urschel’s sign) [2, 6]. [thrombosisjournal.biomedcentral.com]
- Hypertension
[…] malignancies, the use of oral contraceptives, asparaginase, epoetin alfa and tamoxifen, pregnancy and puerperium, high altitude, surgery, immobilization, splints or casts, central catheters, heparin-induced thrombocytopenia, trauma, renal diseases, pulmonary hypertension [tanzariello.it]
Management of massive and submassive pulmonary embolism, iliofemoral deep vein thrombosis, and chronic thromboembolic pulmonary hypertension: a scientific statement from the American Heart Association. Circulation. 2011 Apr 26. 123(16):1788-830. [medscape.com]
- Chest Pain
There was no history of chest pain, dyspnoea, cough, fever, bleeding, easy bruising and palpitation. There was no significant history of any past ailment. [japi.org]
The patient denied any numbness or tingling in his arm; headaches; night sweats; fever; weight loss; shortness of breath; current shoulder, chest, or neck pain; or weakness. [academic.oup.com]
- Palpitations
There was no history of chest pain, dyspnoea, cough, fever, bleeding, easy bruising and palpitation. There was no significant history of any past ailment. [japi.org]
Musculoskeletal
- Arm Swelling
Here we report a 45 old female, a coolie by profession, came with complaints of left arm swelling and pain for one month duration. [jmscr.igmpublication.org]
Google Scholar | Medline Skerker RS, Flandry FC : Case presentation: Painless arm swelling in a high school football player Med Sci Sports Exerc 24:1185-1189, 1992. [journals.sagepub.com]
Most patients do have a good outcome with treatment but depending on the state of the subclavian vein, some degree of arm swelling may persist. [statpearls.com]
- Contusion
Experimental studies on venous thrombosis: effect of coagulants, procoagulants and vessel contusion. Thromb Haemost. 1985 Dec 17. 54(4):866-70. [Medline]. Wessler S, Reimer SM, Sheps MC. [medscape.com]
Face, Head & Neck
- Neck Swelling
The next day, a neck and a pharyngeal swelling together with a torticollis appeared, and the patient was evaluated using CT of the neck to rule out extension of the mastoid infection. [tanzariello.it]
Neurologic
- Paresthesia
Arterial TOS is characterized by compression of the subclavian artery, which leads to intimal damage, turbulent blood flow, vessel dilation and occasionally thrombosis.3 This presents clinically as pulselessness, pain, pallor, paresthesia, and coldness [appliedradiology.com]
[…] vein thrombosis,10 similar guidelines are less established for upper extremity deep vein thrombosis due to its idiopathic onset and wide range in symptom severity.3,11 In this particular case, the patient presented with swelling, venous distention, and paresthesia [journals.healio.com]
In the Adson test,4 the head is turned toward the affected shoulder in slight extension and abduction while the patient inhales as the radial pulse is palpated.4 Hyperabduction and external rotation while checking for paresthesia or changes in radial [ncbi.nlm.nih.gov]
Patients complaining of neuropathic symptoms warrant nerve conduction studies, although the venous swelling can sometimes produce paresthesias unrelated to neurogenic TOS (16,24). [cdt.amegroups.com]
Workup
His chest radiograph and blood test results were normal, and a hypercoagulable workup was started. [degruyter.com]
Additional workup to exclude hypercoagulable state in the form of antiphospholilpid antibody, factor V, Leyden, protein S and C and antithrombin III were within normal levels with no gross abnormality suggestive of thrombophilic state. [thrombosisjournal.biomedcentral.com]
Laboratory workup includes thrombophilia panel (protein C and S levels, antithrombin levels, prothrombin gene mutation analysis, factor V Leiden mutation testing, among others) and D-dimer levels. [statpearls.com]
Treatment
We report a case of Paget-Schroetter syndrome in a young male weight-lifter and discuss treatment strategies suggested by the current literature. [unboundmedicine.com]
Anticoagulation alone for treatment of PSS is generally not recommended. [cdt.amegroups.com]
Conservative Treatment Nonsurgical treatment using anticoagulation alone can result in acute pulmonary embolism in 6% to 15%6 and residual venous obstruction in over 75% of patients.3 Outcomes are poor with the use of anticoagulation treatment as a single [ncbi.nlm.nih.gov]
Conclusion While timely treatment is critical, knowledge of this syndrome is necessary for accurate diagnosis and subsequent treatment. Additionally, treatment cannot be presumed to be consistent with lower extremity deep vein thrombosis. [degruyter.com]
Deep vein thrombosis of the axillary-subclavian veins: Epidemiologic data, effects of different types of treatment and late sequelae. [journals.healio.com]
Prognosis
Treatment and prognosis The thrombus is treated with anticoagulation and catheter-directed thrombolysis, after which surgical decompression is performed. [radiopaedia.org]
Microchapters Home Patient Information Overview Historical Perspective Classification Pathophysiology Causes Differentiating Paget-Schroetter disease from other Diseases Epidemiology and Demographics Risk Factors Screening Natural History, Complications and Prognosis [wikidoc.org]
The sooner treatment is initiated, the better the prognosis and the sooner the return to sport. Footnotes The following authors declared potential conflicts of interest: Nathan A. [ncbi.nlm.nih.gov]
Prognosis A combination of thrombolysis and thoracic outlet decompression may be successful in up to 90% of the patients. [statpearls.com]
Etiology
Klinicheskaia Khirurgiia 5: 62-64, 1969 Research on the etiology of the Paget-v.-Schrötter syndrome. Fortschritte auf dem Gebiete der Rontgenstrahlen und der Nuklearmedizin 105(6): 865-877, 1966 Paget-Schrotter Syndrome. Report of a case. [eurekamag.com]
This additional information about his occupation led to the realization that PSS or effort thrombosis could be an etiology of ASVT in the context of arm activity. [hindawi.com]
Venogram is a consideration CT Useful to exclude other etiologies Venogram is a consideration Venography Indicated if high clinical concern, negative ultrasound Diagnostic and can be therapeutic Can be performed with distal peripheral vein Findings Occlusion [wikism.org]
Hence, there is an urgent need for increasing physician awareness about risk factors, etiology and the management of this unique and relatively infrequent disorder. [westjem.com]
Conclusion In addition to the unusual location in the left upper extremity in our case, the absence of common etiologic factors makes our case of Paget-Schroetter Syndrome a very unique one. [thrombosisjournal.biomedcentral.com]
Epidemiology
Deep vein thrombosis of the axillary-subclavian veins: Epidemiologic data, effects of different types of treatment and late sequelae. [journals.healio.com]
Paget-Schroetter disease Microchapters Home Patient Information Overview Historical Perspective Classification Pathophysiology Causes Differentiating Paget-Schroetter disease from other Diseases Epidemiology and Demographics Risk Factors Screening Natural [wikidoc.org]
Deep vein thrombosis of the axillary-subclavian veins: epidemiologic data, effects of different types of treatment and late sequelae. Eur J Vasc Surg 1988;2:161-5. ↑ Prandoni P, Bernardi E. Upper extremity deep vein thrombosis. [wikism.org]
Epidemiology of weight training-related injuries presenting to United States emergency departments, 1990 to 2007. Am J Sports Med. 2010 ; 38 : 765 – 771. 4 Farrar TA, Rankin G, Chatfield M. [academic.oup.com]
Epidemiology PSS is more commonly seen in younger patients (in their 20s and 30s) with a male to female ratio of 2:1. Often these patients will not have any other significant medical comorbidities. [statpearls.com]
Pathophysiology
This activity reviews the pathophysiology of paget schroetter syndrome and highlights the role of the interprofessional team in its management. Objectives: Describe the pathophysiology of paget schroetter syndrome. [statpearls.com]
Prevention
Prevention of pulmonary embolism and deep vein thrombosis with low dose aspirin: Pulmonary Embolism Prevention (PEP) trial. Lancet. 2000 Apr 15. 355(9212):1295-302. [Medline]. Prevention of thromboembolism in spinal cord injury. [medscape.com]
Diagnosis is usually confirmed with an ultrasound.[7] These DVTs have the potential to cause a pulmonary embolism.[8] Diagnosis[edit] Duplex ultrasonography MR Venography[citation needed] Prevention[edit] Prevention of Paget–Schroetter disease can be [en.wikipedia.org]
No plans for extended monitoring or prevention of reoccurrence were documented. [journals.healio.com]