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{{SK}}  Paget-von Schrötter disease  
{{SK}}  Paget-von Schrötter disease  


'''Paget-Schroetter disease''' refers to [[deep vein thrombosis]] of an upper extremity vein, including the [[axillary vein]] or [[subclavian vein]].
==[[Paget-Schroetter disease overview|Overview]]==


==Presentation==
==[[Paget-Schroetter disease historical perspective|Historical Perspective]]==
The syndrome is also known as “effort-induced thrombosis” as it has been reported to occur after vigorous activity, though it can also occur spontaneously.


It usually presents in young and otherwise healthy patients, males more often than females.
==[[Paget-Schroetter disease classification|Classification]]==


Symptoms include sudden onset of pain, warmth, redness, and swelling in the arm. These DVT's should be treated as an emergency, but rarely cause fatal pulmonary emboli. 
==[[Paget-Schroetter disease pathophysiology|Pathophysiology]]==


==Treatment==
==[[Paget-Schroetter disease causes|Causes]]==
 
==[[Paget-Schroetter disease differential diagnosis|Differentiating Paget-Schroetter disease from other Diseases]]==
 
==[[Paget-Schroetter disease epidemiology and demographics|Epidemiology and Demographics]]==
 
==[[Paget-Schroetter disease risk factors|Risk Factors]]==


The traditional treatment for thrombosis is the same as for a lower extremity deep vein thrombosis, and involves [[anticoagulation]] with [[heparin]] (generally [[low molecular weight heparin]]) with a transition to [[warfarin]]. 


However, J. Ernesto Molina, MD, a vascular surgeon at the University of Minnesota, has expressed the following opinion:<ref>{{cite web |url=http://www.circ.ahajournals.org/cgi/content/full/111/9/e118#R2-160023 |title=Letter Regarding Article by Martinelli et al, "Risk Factors and Recurrence Rate of Primary Deep Vein Thrombosis of the Upper Extremities" * Response -- Molina et al. 111 (9): e118 -- Circulation |accessdate=2007-07-02 |format= |work=}}</ref>
"The current acceptable treatment for that condition is lytic therapy followed by surgery. The patients were followed up to investigate the rate of recurrence. However, if surgery is not done, the problem will invariably recur.2–4 If patients are treated with only anticoagulants and even thrombolytics but no surgery, I expect the recurrence rate to be high."  Because "most of the patients who suffer this condition do not have any abnormality in their coagulation mechanism" and in fact suffer from "a direct injury to the endothelium," the "treatment for Paget-Schroetter syndrome ... entails the use of thrombolytics ''followed by surgery'' to decompress the thoracic inlet and widening of the vein, usually with a vein patch."


==Eponym==


It is named for James Paget<ref>{{WhoNamedIt|synd|1924}}</ref><ref>J. Paget. On gouty and some other forms of phlebitis.
==[[Paget-Schroetter disease screening|Screening]]==
St. Bartholomew’s Hospital Reports, London, 1866, 2: 82-92.</ref> and Leopold von Schrötter.<ref>L. von Schrötter. Erkrankungen der Gefässe. Nothnagel’s Handbuch der speciellen Pathologie und Therapie, 1901. Volume XV, II. Theil, II. Hälfte: Erkrankungen der Venen. Wien, Hölder, 1899: 533–535.</ref>


==See also==
==[[Paget-Schroetter disease natural history, complications and prognosis|Natural History, Complications and Prognosis]]==
* [[Thoracic outlet syndrome]], a possible cause of blot clots in arms


== Trivia ==
==Diagnosis==
[[Paget-Schroetter disease history and symptoms| History and Symptoms]] | [[Paget-Schroetter disease physical examination | Physical Examination]] |[[Paget-Schroetter disease laboratory findings|Laboratory Findings]] | [[Paget-Schroetter disease chest x ray|Chest X Ray]] |  [[Paget-Schroetter disease CT|CT]] | [[Paget-Schroetter disease MRI|MRI]] | [[Paget-Schroetter disease ultrasound|Ultrasound]] | [[Paget-Schroetter disease other imaging findings|Other Imaging Findings]] | [[Paget-Schroetter disease other diagnostic studies|Other Diagnostic Studies]]


The father of a patient used Google to diagnose his son's Paget-Von Schrötter syndrome by querying on the symptoms, and it resulted in one of the first descriptions of "googling for diagnosis".<ref>{{Cite journal
==Treatment==
| author = Hangwi Tang & Jennifer Hwee Kwoon Ng
[[Paget-Schroetter disease medical therapy|Medical Therapy]] | [[Paget-Schroetter disease surgery|Surgery]] | [[Paget-Schroetter disease primary prevention|Primary Prevention]] | [[Paget-Schroetter disease secondary prevention|Secondary Prevention]] | [[Paget-Schroetter disease cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] | [[Paget-Schroetter disease future or investigational therapies|Future or Investigational Therapies]]
| title = Googling for a diagnosis—use of Google as a diagnostic aid: internet based study
| journal = [[BMJ]]
| volume = 333
| pages = 1143-1145
| month = December
| year = 2006
| doi = 10.1136/bmj.39003.640567.AE
}}</ref>


==References==
{{reflist|2}}


==External links==
==Case Studies==
* [http://rad.usuhs.mil/medpix/medpix.html?mode=single&comebackto=mode%3Dcat_browse&recnum=4200 Overview] at [[Uniformed Services University of the Health Sciences]]
[[Paget-Schroetter disease case study one|Case#1]]


{{Circulatory system pathology}}
{{Circulatory system pathology}}
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[[Category:Angiology]]
[[Category:Angiology]]
[[Category:cardiology]]
[[Category:cardiology]]
[[Category:Disease]]


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{{WH}}
{{WS}}
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Revision as of 17:17, 21 September 2012

Paget-Schroetter disease
Anterior view of right upper limb and thorax
ICD-10 I82.8
ICD-9 453.8
DiseasesDB 34349

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Synonyms and keywords: Paget-von Schrötter disease

Overview

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Differentiating Paget-Schroetter disease from other Diseases

Epidemiology and Demographics

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Screening

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Diagnosis

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