Key result
Exercise-associated VTE in athletes involves major risk factors in ~70% of cases and frequent misdiagnosis.
Why the study?
Venous thromboembolic events have been reported in otherwise low-risk healthy athletes after acute aerobic exercise, prompting a review of commonalities and return-to-play recommendations.
What are the common risk factors, presenting symptoms, and return-to-play recommendations for athletes who develop venous thromboembolism following acute aerobic exercise?
What are the common risk factors, presenting symptoms, and return-to-play recommendations for athletes who develop venous thromboembolism following acute aerobic exercise?
Venous thromboembolism in athletes following aerobic exercise is often associated with identifiable risk factors and is frequently misdiagnosed, highlighting the need for improved clinical awareness and standardized return-to-play guidelines.
Raises awareness of VTE misdiagnosis in athletes with risk factors; leaves open standardized return-to-play guidelines.
Venous thromboembolic (VTE) events such as deep vein thrombosis (DVT) and pulmonary embolism (PE) have been reported in otherwise low-risk healthy athletes following acute bouts of aerobic exercise. PURPOSE: To review case reports and assess the commonalities of athletic individuals with VTE, as well as return-to-play (RTP) recommendations. METHODS: We reviewed 47 reports (20 DVTs, 15 PEs, and 12 DVTs/PEs, 19 women) of trained individuals who were diagnosed with DVT and/or PE following aerobic exercise. We assessed frequency of VTE risk factors, presenting symptoms, and RTP recommendations. RESULTS: The age of women (24.6 ± 7.0 years) was lower (P < .01) than of men (40.6 ± 13.6 years). Of the 19 women, 14 (73.7%) used oral contraceptives. Thirteen cases (27.7%) reported a recent period of prolonged inactivity (>1 hour), and another 12 cases were found to have an antithrombin disorder following testing after diagnosis. The most frequently reported symptoms were muscle pain in 26 of 32 (81.3%) DVT or DVT/PE cases, and dyspnea in 21 of 27 (77.8%) PE or DVT/PE cases. Despite these common symptoms, the estimated time from first report of symptoms to confirmed diagnosis was 56.3 ± 118.7 days and 25 cases (53.2%) were initially misdiagnosed. Twenty-three cases (48.9%) did not report RTP recommendations, and those which did varied widely. CONCLUSIONS: Thirty-two cases (~70%) had at least one of three major risk factors, suggesting that many cases of VTE in athletes may be preventable with better education and awareness. The wide variety of RTP recommendations highlights the need for standardized guidelines in this population.
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Taylor et al. (2019) conducted a review in Venous thromboembolic (VTE) events (n=47). Acute aerobic exercise was evaluated on Frequency of VTE risk factors, presenting symptoms, and return-to-play recommendations. Acute aerobic exercise-associated VTE in 47 athletes involved at least one major risk factor in ~70% of cases, and 53.2% were initially misdiagnosed, suggesting many cases may be preventable.
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