Division of Cardiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
School of Medicine, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil.
Phys Sportsmed. 2024 Aug;52(4):414-420. doi: 10.1080/00913847.2023.2256642. Epub 2023 Sep 15.
Paget-Schroetter Syndrome (PSS) is a rare condition characterized by spontaneous thrombosis of the axillary-subclavian vein that occurs predominantly in young athletes engaged in repetitive overhead upper extremity motion, for instance, weightlifting, swimming, baseball, and tennis. PSS is usually a consequence of chronic repetitive microtrauma to the vein intima due to compression of the axillary-subclavian vein by the thoracic outlet structures. This chronic injury can then be acutely exacerbated by vigorous exercise done over a brief period, accelerating thrombus formation. Lack of PSS awareness leads to underdiagnosis, misdiagnosis, or late diagnosis, which can pose life-threatening risks to patients, including pulmonary embolism (PE) and recurrent thrombosis. This case report of a 20-year-old male college athlete exposes a PE caused by PSS, potentially worsened by a delay in diagnosis. Early suspicion and proper management are crucial for optimizing long-term outcomes and facilitating limb rehabilitation. The recommended approach involves early catheter-directed thrombolysis followed by thoracic outlet decompression.
佩吉特-施罗氏综合征（Paget-Schroetter Syndrome，PSS）是一种罕见的疾病，其特征是腋-锁骨下静脉自发性血栓形成，主要发生在从事重复性上肢过头运动的年轻运动员中，例如举重、游泳、棒球和网球。PSS 通常是由于上肢过头运动导致静脉内膜的慢性反复微创伤，从而使腋-锁骨下静脉受到胸廓出口结构的压迫。这种慢性损伤随后可能会在短时间内剧烈运动时急性加剧，加速血栓形成。对 PSS 认识不足会导致漏诊、误诊或延迟诊断，这会给患者带来危及生命的风险，包括肺栓塞（PE）和复发性血栓形成。本病例报告介绍了一名 20 岁的男性大学生运动员因 PSS 导致的 PE，可能因诊断延迟而加重。早期怀疑和适当的治疗对于优化长期预后和促进肢体康复至关重要。建议的方法包括早期导管引导的溶栓治疗，随后进行胸廓出口减压。
