Paget–Schroetter disease
<templatestyles src="Module:Hatnote/styles.css"></templatestyles>
| Paget-Schrotter disease | |
|---|---|
Anterior view of right upper limb and thorax
|
|
| Classification and external resources | |
| Specialty | Lua error in Module:Wikidata at line 446: attempt to index field 'wikibase' (a nil value). |
| ICD-10 | I82.8 |
| ICD-9-CM | 453.8 |
| DiseasesDB | 34349 |
| eMedicine | med/2772 |
| Patient UK | Paget–Schroetter disease |
Paget–Schroetter disease, also known as Paget–von Schrötter 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.[1]
History
The condition is named after two men. James Paget[2] first proposed the idea of venous thrombosis causing upper extremity pain and swelling,[3] and Leopold von Schrötter later linked the clinical syndrome to thrombosis of the axillary and subclavian veins.[4]
Signs and symptoms
The condition is relatively rare.[5] 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 due to anatomic abnormality such as clavicle impingement[8] or spontaneously. It may develop as a sequela of thoracic outlet syndrome. It is differentiated from secondary causes of upper extremity caused by intravascular catheters.[7] 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.[9]
Symptoms may include sudden onset of pain, warmth, redness, blueness and swelling in the arm. Diagnosis is usually confirmed with an ultrasound.[10] These DVTs have the potential to cause a pulmonary embolism.[11]
Treatment
The traditional treatment for thrombosis is the same as for a lower extremity DVT, and involves systemic anticoagulation to prevent a pulmonary embolus.[12] Some have also recommended thrombolysis with catheter directed alteplase.[13] If there is thoracic outlet syndrome or other anatomical cause then surgery can be considered to correct the underlying defect.[14]
References
- ↑ Lua error in package.lua at line 80: module 'strict' not found.
- ↑ Paget-von Schrötter disease at Who Named It?
- ↑ Lua error in package.lua at line 80: module 'strict' not found.
- ↑ 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.
- ↑ Lua error in package.lua at line 80: module 'strict' not found.
- ↑ Lua error in package.lua at line 80: module 'strict' not found.
- ↑ 7.0 7.1 Lua error in package.lua at line 80: module 'strict' not found.
- ↑ Lua error in package.lua at line 80: module 'strict' not found.
- ↑ Lua error in package.lua at line 80: module 'strict' not found.
- ↑ Lua error in package.lua at line 80: module 'strict' not found.
- ↑ Lua error in package.lua at line 80: module 'strict' not found.
- ↑ Lua error in package.lua at line 80: module 'strict' not found.
- ↑ Lua error in package.lua at line 80: module 'strict' not found.
- ↑ Lua error in package.lua at line 80: module 'strict' not found.
External links
- Overview at Uniformed Services University of the Health Sciences
- An image and case description from the NEJM
