Paget–Schroetter disease
| Paget-Schrotter disease | |
| Classification and external resources | |
| |
|---|---|
| Anterior view of right upper limb and thorax | |
| ICD-10 | I82.8 |
| ICD-9 | 453.8 |
| DiseasesDB | 34349 |
| eMedicine | med/2772 |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Assosciate Editor(s)-In-Chief: Prashanth Saddala M.B.B.S
Synonyms and keywords: Paget-von Schrotter disease; effort-induced thrombosis; Subclavian vein thrombosis; Paget-von Schrötter syndrome
Overview
Paget-Schroetter disease is a form of upper extremity deep vein thrombosis (DVT), a medical condition in which blood clots form in the deep veins of the arms. These DVTs typically occur in the axillary or subclavian veins.
Historical Perspective
The condition is named after two men. James Paget[1] first proposed the idea of venous thrombosis causing upper extremity pain and swelling,[2] and Leopold von Schrötter later linked the clinical syndrome to thrombosis of the axillary and subclavian veins.[3] Paget-Schroetter syndrome was described once for a viola player who suddenly increased practice time 10-fold, creating enough repetitive pressure against the brachiocephalic and external jugular veins to cause thrombosis.[4]
Epidemiology and Demographics
The condition is relatively rare.[5]
Natural history, Complications and Prognosis
These DVTs rarely cause fatal pulmonary embolism.
Diagnosis
History and symptoms
It usually presents in young and otherwise healthy patients, and also occurs more often in males than females.
The syndrome also became known as "effort-induced thrombosis" in the 1960s,[6] as it has been reported to occur after vigorous activity,[7] though it can also occur spontaneously.
It may develop as a sequela of thoracic outlet syndrome.
Symptoms may include
- Sudden onset of pain
- Warmth, redness, blueness and swelling in the arm.
Treatment
The traditional treatment for thrombosis is the same as for a lower extremity DVT, and involves anticoagulation with heparin (generally low molecular weight heparin) with a transition to warfarin.
Alternative treatment is thrombolytic therapy to open up the vein followed by first-rib resection during the same hospital admission and not waiting for a repeat episode.
See also
- Thoracic outlet syndrome, a possible cause of blood clots in arms
References
- ↑ Template:WhoNamedIt
- ↑ Paget J (1866). "On gouty and some other forms of phlebitis". St. Bartholomew's Hospital Reports. 2: 82–92.
- ↑ 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.
- ↑ Reina, Nick J.; Honet, Joseph C.; Brown, William; Beitman, Max; Chodoroff, Gary (1988). "Paget-Schroetter syndrome in a viola player". Medical Problems of Performing Artists. 3 (1): 24.
- ↑ Hughes, ES (1949). "Venous obstruction in the upper extremity; Paget-Schroetter's syndrome; a review of 320 cases". Surg Gynecol Obstet. 88 (2): 89. PMID 18108679. More than one of
|pages=and|page=specified (help) - ↑ Drapanas, T; Curran, WL (1966). "Thrombectomy in the treatment of "effort" thrombosis of the axillary and subclavian veins". Journal of Trauma (6): 107.
- ↑ Flinterman LE; Van Der Meer FJ; Rosendaal FR; Doggen CJ (2008). "Current perspective of venous thrombosis in the upper extremity". Journal of Thrombosis and Haemostasis. 6 (8): 1262–6. doi:10.1111/j.1538-7836.2008.03017.x. PMID 18485082. Unknown parameter
|month=ignored (help)