Best Practice Case Studies-Anticoagulation in Athletes

Pdf Summary

The document discusses the management and return-to-play guidelines for athletes suffering from venous thromboembolism (VTE), including deep venous thrombosis (DVT) and pulmonary embolism (PE). VTE is a significant source of health issues and can occur in athletes, contrary to the protective nature of physical activity against such conditions. The treatment protocols for athletes with VTE align closely with those for the general population, involving anticoagulation and early mobilization rather than bed rest. Thrombolysis or surgical intervention may be considered for select cases, particularly in upper extremity DVT (UEDVT).<br /><br />After beginning anticoagulation treatment, athletes are advised to gradually resume activities of daily living (ADL), shifting to a structured return-to-training program post-ADL mastery. Contact sports should be avoided until anticoagulation therapy ends. Despite various case studies, standardized statistics on VTE incidence among athletes are lacking, and there are no established return-to-play guidelines.<br /><br />DVT affects over 250,000 people annually in the U.S., with symptoms ranging from leg swelling to pulmonary embolism, and potential long-term effects such as postthrombotic syndrome (PTS), a chronic condition ensuing from DVT. Risk factors include immobility, trauma, and dehydration, which athletes may encounter due to rigorous training and competition schedules.<br /><br />Diagnostic approaches involve clinical prediction models and imaging like ultrasounds or CT venography. Treatment focuses on anticoagulation combining low molecular weight heparin (LMWH) and vitamin K antagonists. Compression therapies may reduce PTS risk, whereas surgical or catheter-directed interventions are considered in complex cases.<br /><br />Return-to-play strategies suggest a gradual increase in activity intensity and discourage participation in contact sports until full recovery. Preventative measures include hydration and compression stockings during prolonged travel or physical strain. Further research is recommended to refine treatment and prevention strategies tailored to athletes. More studies, particularly of a randomized controlled nature, are necessary to establish safe return-to-play timelines.

Meta Tag

Edition 2nd Edition

Related Case 2nd Edition, CASE 42

Topic Pulmonary

Keywords

2nd Edition, CASE 42

2nd Edition

Pulmonary

venous thromboembolism

deep venous thrombosis

pulmonary embolism

athlete management

anticoagulation therapy

return-to-play guidelines

postthrombotic syndrome

compression therapy

diagnostic imaging

preventative measures