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Venous thromboemboli associated with acute aerobic exercise: A review of case report commonalities
Author(s) -
Taylor Beth A.,
Parducci Paul M.,
Zaleski Amanda L.,
Panza Gregory A.,
Pescatello Linda S.,
Thompson Paul D.
Publication year - 2019
Publication title -
scandinavian journal of medicine and science in sports
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.575
H-Index - 115
eISSN - 1600-0838
pISSN - 0905-7188
DOI - 10.1111/sms.13505
Subject(s) - medicine , pulmonary embolism , deep vein , athletes , venous thrombosis , physical therapy , thrombosis , venous thromboembolism
Venous thromboembolic (VTE) events such as deep vein thrombosis (DVT) and pulmonary embolism (PE) have been reported in otherwise low‐risk healthy athletes following acute bouts of aerobic exercise. Purpose To review case reports and assess the commonalities of athletic individuals with VTE, as well as return‐to‐play (RTP) recommendations. Methods We reviewed 47 reports (20 DVTs, 15 PEs, and 12 DVTs/PEs, 19 women) of trained individuals who were diagnosed with DVT and/or PE following aerobic exercise. We assessed frequency of VTE risk factors, presenting symptoms, and RTP recommendations. Results The age of women (24.6 ± 7.0 years) was lower ( P < .01) than of men (40.6 ± 13.6 years). Of the 19 women, 14 (73.7%) used oral contraceptives. Thirteen cases (27.7%) reported a recent period of prolonged inactivity (>1 hour), and another 12 cases were found to have an antithrombin disorder following testing after diagnosis. The most frequently reported symptoms were muscle pain in 26 of 32 (81.3%) DVT or DVT/PE cases, and dyspnea in 21 of 27 (77.8%) PE or DVT/PE cases. Despite these common symptoms, the estimated time from first report of symptoms to confirmed diagnosis was 56.3 ± 118.7 days and 25 cases (53.2%) were initially misdiagnosed. Twenty‐three cases (48.9%) did not report RTP recommendations, and those which did varied widely. Conclusions Thirty‐two cases (~70%) had at least one of three major risk factors, suggesting that many cases of VTE in athletes may be preventable with better education and awareness. The wide variety of RTP recommendations highlights the need for standardized guidelines in this population.