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Venous Thromboembolism in Athletes, Sports Medicine

William M. Collins, DO and Alejandro Centurion, MD Reviewed 04/2019
 


BASICS

DESCRIPTION

  • Venous thromboembolism (VTE) is a condition in which a blood clot (thrombus) forms in a vein.

  • When a thrombus occurs in the “deep veins” of the extremities or pelvis, it is called a d...

DIAGNOSIS

Wells criteria for DVT 1[A]: 
Wells criteria for PE 1[A
  • A low or intermediate pretest probability of PE/DVT (Wells) with a negative D-dimer effectively rules out PE/DVT.

  • A high pretest probab...

TREATMENT

Outpatient treatment: 
  • Anticoagulation 1,4,5[A]

  • Factor Xa inhibitors or direct thrombin inhibitors (DTI) are considered treatment of choice 4[A]:

    • Oral agents

    • Do not require laboratory monitoring

    • ...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

No monitoring required for DTI or factor Xa inhibitors. INR levels should be evaluated frequently until stable with a target range between two a...

REFERENCES

1
Di Nisio M, Van Es N, Büller HR. Deep vein thrombosis and pulmonary embolism. Lancet.  2016;388(10063):3060–3073.
2
Segal JB, Eng J, Tamariz LJ, et al. Review of the evidence on diagnos...

ADDITIONAL READING

  • Berkowitz JN, Moll S. Athletes and blood clots: individualized, intermittent anticoagulation management. J Thromb Haemost.  2017;15(6):1051–1054.

  • Bishop M, Astolfi M, Padegimas ...

CLINICAL PEARLS

  • A DVT is associated with risk factors noted in Virchow triad of:

    • Venous stasis of an alteration in normal blood flow.

    • Vascular endothelial injury.

    • Hypercoagulability.

  • Essential workup incl...

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