Deep Vein Thrombosis and Pulmonary Embolism in a Female Football Player with Calf Pain

Rodrigo Moreira Sales; Ednei Costa Maia; Rafael Moreira Sales; Gustavo Gonçalves Arliani; Carlos Tadeu Moreno; Tathiana Rebizzi Parmigiano

doi:doi:10.11648/j.cmr.20170603.11

Deep Vein Thrombosis and Pulmonary Embolism in a Female Football Player with Calf Pain

Rodrigo Moreira Sales, Ednei Costa Maia, Rafael Moreira Sales, Gustavo Gonçalves Arliani, Carlos Tadeu Moreno, Tathiana Rebizzi Parmigiano

Published in Clinical Medicine Research (Volume 6, Issue 3)

Received: 8 February 2017 Accepted: 7 March 2017 Published: 23 March 2017

Views: Downloads:

Download PDF

Share This Article

Twitter
Linked In
Facebook

Abstract

Although many health professionals believe that exercise protects the athletes against thrombosis, it is discussed whether elite athletes are exposed to many thrombogenic acquired risk factors such as: dehydration, hemoconcentration, repeated microtraumas and extended periods of immobilization during travel or injury. Additionally, the use of combined oral contraceptive (COC) may increases the risk of venous thrombosis fourfold in healthy women. We report a case of a 21-years-old professional female football athlete who developed deep vein thrombosis (DVT) followed by pulmonary embolism (PE). The outpatient hypercoagulability workup was negative and the case was associated to the use of COC pills. The patient was treated with rivaroxaban for 5 months, with complete resolution of the symptoms. There are a few cases in the literature of venous thromboembolism (VTE) involving athletes. Cases of VTE attributable to the use of COC are extremely rare in this population. The diagnosis of VTE in athletes is a challenge for physicians, because the symptoms may erroneously be confused with musculoskeletal complaints. Team physicians who work with female athletes should be alert to modifiable risk factors for VTE, as well as able to perform the early diagnosis and initial clinical management of this condition. DVT should be considered as a differential diagnosis of calf pain in women, especially in athletes, due to the well-defined increase on the risk of thrombosis with the use of COC pills.

Published in	Clinical Medicine Research (Volume 6, Issue 3)
DOI	10.11648/j.cmr.20170603.11
Page(s)	64-68
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2017. Published by Science Publishing Group

Keywords

Venous Thrombosis, Pulmonary Embolism, Combined Oral Contraceptives, Athletes, Football

References

[1]	C. Kearon, Natural history of venous thromboembolism. Circulation, 2003. 107(23 suppl 1): p. I-22-I-30.
[2]	I. A. Naess, et al., Incidence and mortality of venous thrombosis: a population-based study. J Thromb Haemost, 2007. 5(4): p. 692-9.
[3]	K. Tao and M. Davenport, Deep venous thromboembolism in a triathlete. The Journal of emergency medicine, 2010. 38(3): p. 351-353.
[4]	S. V. Konstantinides, et al., 2014 ESC guidelines on the diagnosis and management of acute pulmonary embolism. Eur Heart J, 2014. 35(43): p. 3033-69, 3069a-3069k.
[5]	White, R. H., The epidemiology of venous thromboembolism. Circulation, 2003. 107(23 suppl 1): p. I-4-I-8.
[6]	C. Huerta, S. Johansson, M. Wallander, and L. A. García Rodríguez, Risk factors and short-term mortality of venous thromboembolism diagnosed in the primary care setting in the united kingdom. Archives of Internal Medicine, 2007. 167(9): p. 935-943.
[7]	V. F. Tapson, Acute pulmonary embolism. New England Journal of Medicine, 2008. 358(10): p. 1037-1052.
[8]	K. Moffatt, P. J. Silberberg, and D. J. Gnarra, Pulmonary embolism in an adolescent soccer player: a case report. Med Sci Sports Exerc, 2007. 39(6): p. 899-902.
[9]	D. L. Ornstein and M. Cushman, Factor V Leiden. Circulation, 2003. 107(15): p. e94-e97.
[10]	K. Erickson and M. E. Powers, Factor V Leiden thrombophilia in a female collegiate soccer athlete: a case report. Journal of Athletic Training, 2013. 48(3): p. 431-435.
[11]	T. Hilberg, D. Jeschke, and H. H. Gabriel, Hereditary thrombophilia in elite athletes. Med Sci Sports Exerc, 2002. 34(2): p. 218-21.
[12]	G. Grabowski, W. K. Whiteside and M. Kanwisher, Venous thrombosis in athletes. Journal of the American Academy of Orthopaedic Surgeons, 2013. 21(2): p. 108-117.
[13]	M. de Bastos, et al., Combined oral contraceptives: venous thrombosis. Cochrane Database Syst Rev, 2014(3): p. Cd010813.
[14]	WHO, W. H. O., Medical eligibility criteria for contraceptive use. 2015.
[15]	M. C. Kleinegris, A. J. ten Cate-Hoek, and H. ten Cate, Coagulation and the vessel wall in thrombosis and atherosclerosis. Pol Arch Med Wewn, 2012. 122(11): p. 557-66.
[16]	C. Meyering, and T. Howard, Hypercoagulability in athletes. Current sports medicine reports, 2004. 3(2): p. 77-83.
[17]	D. Dupras, et al., Venous thromboembolism diagnosis and treatment. Institute for Clinical Systems Improvement, 2013.
[18]	C. Kearon, et al., Antithrombotic therapy for vte disease: Chest guideline and expert panel report. Chest, 2016. 149(2): p. 315-352.
[19]	B. D. Levine, et al., Eligibility and disqualification recommendations for competitive athletes with cardiovascular abnormalities: Task Force 1: Classification of sports: dynamic, static, and impact. A. Scientific Statement from the American Heart Association and American College of Cardiology, 2015. 132(22): p. e262-e266.

Cite This Article

Plain Text BibTeX RIS

APA Style

Rodrigo Moreira Sales, Ednei Costa Maia, Rafael Moreira Sales, Gustavo Gonçalves Arliani, Carlos Tadeu Moreno, et al. (2017). Deep Vein Thrombosis and Pulmonary Embolism in a Female Football Player with Calf Pain. Clinical Medicine Research, 6(3), 64-68. https://doi.org/10.11648/j.cmr.20170603.11

Copy | Download

ACS Style

Rodrigo Moreira Sales; Ednei Costa Maia; Rafael Moreira Sales; Gustavo Gonçalves Arliani; Carlos Tadeu Moreno, et al. Deep Vein Thrombosis and Pulmonary Embolism in a Female Football Player with Calf Pain. Clin. Med. Res. 2017, 6(3), 64-68. doi: 10.11648/j.cmr.20170603.11

Copy | Download

AMA Style

Rodrigo Moreira Sales, Ednei Costa Maia, Rafael Moreira Sales, Gustavo Gonçalves Arliani, Carlos Tadeu Moreno, et al. Deep Vein Thrombosis and Pulmonary Embolism in a Female Football Player with Calf Pain. Clin Med Res. 2017;6(3):64-68. doi: 10.11648/j.cmr.20170603.11

Copy | Download

@article{10.11648/j.cmr.20170603.11,
  author = {Rodrigo Moreira Sales and Ednei Costa Maia and Rafael Moreira Sales and Gustavo Gonçalves Arliani and Carlos Tadeu Moreno and Tathiana Rebizzi Parmigiano},
  title = {Deep Vein Thrombosis and Pulmonary Embolism in a Female Football Player with Calf Pain},
  journal = {Clinical Medicine Research},
  volume = {6},
  number = {3},
  pages = {64-68},
  doi = {10.11648/j.cmr.20170603.11},
  url = {https://doi.org/10.11648/j.cmr.20170603.11},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.cmr.20170603.11},
  abstract = {Although many health professionals believe that exercise protects the athletes against thrombosis, it is discussed whether elite athletes are exposed to many thrombogenic acquired risk factors such as: dehydration, hemoconcentration, repeated microtraumas and extended periods of immobilization during travel or injury. Additionally, the use of combined oral contraceptive (COC) may increases the risk of venous thrombosis fourfold in healthy women. We report a case of a 21-years-old professional female football athlete who developed deep vein thrombosis (DVT) followed by pulmonary embolism (PE). The outpatient hypercoagulability workup was negative and the case was associated to the use of COC pills. The patient was treated with rivaroxaban for 5 months, with complete resolution of the symptoms. There are a few cases in the literature of venous thromboembolism (VTE) involving athletes. Cases of VTE attributable to the use of COC are extremely rare in this population. The diagnosis of VTE in athletes is a challenge for physicians, because the symptoms may erroneously be confused with musculoskeletal complaints. Team physicians who work with female athletes should be alert to modifiable risk factors for VTE, as well as able to perform the early diagnosis and initial clinical management of this condition. DVT should be considered as a differential diagnosis of calf pain in women, especially in athletes, due to the well-defined increase on the risk of thrombosis with the use of COC pills.},
 year = {2017}
}

Copy | Download

TY  - JOUR
T1  - Deep Vein Thrombosis and Pulmonary Embolism in a Female Football Player with Calf Pain
AU  - Rodrigo Moreira Sales
AU  - Ednei Costa Maia
AU  - Rafael Moreira Sales
AU  - Gustavo Gonçalves Arliani
AU  - Carlos Tadeu Moreno
AU  - Tathiana Rebizzi Parmigiano
Y1  - 2017/03/23
PY  - 2017
N1  - https://doi.org/10.11648/j.cmr.20170603.11
DO  - 10.11648/j.cmr.20170603.11
T2  - Clinical Medicine Research
JF  - Clinical Medicine Research
JO  - Clinical Medicine Research
SP  - 64
EP  - 68
PB  - Science Publishing Group
SN  - 2326-9057
UR  - https://doi.org/10.11648/j.cmr.20170603.11
AB  - Although many health professionals believe that exercise protects the athletes against thrombosis, it is discussed whether elite athletes are exposed to many thrombogenic acquired risk factors such as: dehydration, hemoconcentration, repeated microtraumas and extended periods of immobilization during travel or injury. Additionally, the use of combined oral contraceptive (COC) may increases the risk of venous thrombosis fourfold in healthy women. We report a case of a 21-years-old professional female football athlete who developed deep vein thrombosis (DVT) followed by pulmonary embolism (PE). The outpatient hypercoagulability workup was negative and the case was associated to the use of COC pills. The patient was treated with rivaroxaban for 5 months, with complete resolution of the symptoms. There are a few cases in the literature of venous thromboembolism (VTE) involving athletes. Cases of VTE attributable to the use of COC are extremely rare in this population. The diagnosis of VTE in athletes is a challenge for physicians, because the symptoms may erroneously be confused with musculoskeletal complaints. Team physicians who work with female athletes should be alert to modifiable risk factors for VTE, as well as able to perform the early diagnosis and initial clinical management of this condition. DVT should be considered as a differential diagnosis of calf pain in women, especially in athletes, due to the well-defined increase on the risk of thrombosis with the use of COC pills.
VL  - 6
IS  - 3
ER  -

Copy | Download

Author Information

Rodrigo Moreira Sales

Medical Department, Olympic Training and Research Center (COTP), Sao Paulo, Brazil
Ednei Costa Maia

Discipline of Sports Medicine and Physical Activity, Federal University of Sao Paulo (UNIFESP), Sao Paulo, Brazil
Rafael Moreira Sales

Department of Physiotherapy, Estacio de Sa University, Recife, Brazil
Gustavo Gonçalves Arliani
Carlos Tadeu Moreno

Medical Department, Olympic Training and Research Center (COTP), Sao Paulo, Brazil
Tathiana Rebizzi Parmigiano

Department of Gynecology, Federal University of Sao Paulo (UNIFESP), Sao Paulo, Brazil

Download PDF

Sections

Plain Text BibTeX RIS

APA Style

Rodrigo Moreira Sales, Ednei Costa Maia, Rafael Moreira Sales, Gustavo Gonçalves Arliani, Carlos Tadeu Moreno, et al. (2017). Deep Vein Thrombosis and Pulmonary Embolism in a Female Football Player with Calf Pain. Clinical Medicine Research, 6(3), 64-68. https://doi.org/10.11648/j.cmr.20170603.11

Copy | Download

ACS Style

Rodrigo Moreira Sales; Ednei Costa Maia; Rafael Moreira Sales; Gustavo Gonçalves Arliani; Carlos Tadeu Moreno, et al. Deep Vein Thrombosis and Pulmonary Embolism in a Female Football Player with Calf Pain. Clin. Med. Res. 2017, 6(3), 64-68. doi: 10.11648/j.cmr.20170603.11

Copy | Download

AMA Style

Rodrigo Moreira Sales, Ednei Costa Maia, Rafael Moreira Sales, Gustavo Gonçalves Arliani, Carlos Tadeu Moreno, et al. Deep Vein Thrombosis and Pulmonary Embolism in a Female Football Player with Calf Pain. Clin Med Res. 2017;6(3):64-68. doi: 10.11648/j.cmr.20170603.11

Copy | Download

@article{10.11648/j.cmr.20170603.11,
  author = {Rodrigo Moreira Sales and Ednei Costa Maia and Rafael Moreira Sales and Gustavo Gonçalves Arliani and Carlos Tadeu Moreno and Tathiana Rebizzi Parmigiano},
  title = {Deep Vein Thrombosis and Pulmonary Embolism in a Female Football Player with Calf Pain},
  journal = {Clinical Medicine Research},
  volume = {6},
  number = {3},
  pages = {64-68},
  doi = {10.11648/j.cmr.20170603.11},
  url = {https://doi.org/10.11648/j.cmr.20170603.11},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.cmr.20170603.11},
  abstract = {Although many health professionals believe that exercise protects the athletes against thrombosis, it is discussed whether elite athletes are exposed to many thrombogenic acquired risk factors such as: dehydration, hemoconcentration, repeated microtraumas and extended periods of immobilization during travel or injury. Additionally, the use of combined oral contraceptive (COC) may increases the risk of venous thrombosis fourfold in healthy women. We report a case of a 21-years-old professional female football athlete who developed deep vein thrombosis (DVT) followed by pulmonary embolism (PE). The outpatient hypercoagulability workup was negative and the case was associated to the use of COC pills. The patient was treated with rivaroxaban for 5 months, with complete resolution of the symptoms. There are a few cases in the literature of venous thromboembolism (VTE) involving athletes. Cases of VTE attributable to the use of COC are extremely rare in this population. The diagnosis of VTE in athletes is a challenge for physicians, because the symptoms may erroneously be confused with musculoskeletal complaints. Team physicians who work with female athletes should be alert to modifiable risk factors for VTE, as well as able to perform the early diagnosis and initial clinical management of this condition. DVT should be considered as a differential diagnosis of calf pain in women, especially in athletes, due to the well-defined increase on the risk of thrombosis with the use of COC pills.},
 year = {2017}
}

Copy | Download

TY  - JOUR
T1  - Deep Vein Thrombosis and Pulmonary Embolism in a Female Football Player with Calf Pain
AU  - Rodrigo Moreira Sales
AU  - Ednei Costa Maia
AU  - Rafael Moreira Sales
AU  - Gustavo Gonçalves Arliani
AU  - Carlos Tadeu Moreno
AU  - Tathiana Rebizzi Parmigiano
Y1  - 2017/03/23
PY  - 2017
N1  - https://doi.org/10.11648/j.cmr.20170603.11
DO  - 10.11648/j.cmr.20170603.11
T2  - Clinical Medicine Research
JF  - Clinical Medicine Research
JO  - Clinical Medicine Research
SP  - 64
EP  - 68
PB  - Science Publishing Group
SN  - 2326-9057
UR  - https://doi.org/10.11648/j.cmr.20170603.11
AB  - Although many health professionals believe that exercise protects the athletes against thrombosis, it is discussed whether elite athletes are exposed to many thrombogenic acquired risk factors such as: dehydration, hemoconcentration, repeated microtraumas and extended periods of immobilization during travel or injury. Additionally, the use of combined oral contraceptive (COC) may increases the risk of venous thrombosis fourfold in healthy women. We report a case of a 21-years-old professional female football athlete who developed deep vein thrombosis (DVT) followed by pulmonary embolism (PE). The outpatient hypercoagulability workup was negative and the case was associated to the use of COC pills. The patient was treated with rivaroxaban for 5 months, with complete resolution of the symptoms. There are a few cases in the literature of venous thromboembolism (VTE) involving athletes. Cases of VTE attributable to the use of COC are extremely rare in this population. The diagnosis of VTE in athletes is a challenge for physicians, because the symptoms may erroneously be confused with musculoskeletal complaints. Team physicians who work with female athletes should be alert to modifiable risk factors for VTE, as well as able to perform the early diagnosis and initial clinical management of this condition. DVT should be considered as a differential diagnosis of calf pain in women, especially in athletes, due to the well-defined increase on the risk of thrombosis with the use of COC pills.
VL  - 6
IS  - 3
ER  -

Copy | Download