Paget–Schroetter disease

From Wikipedia, the free encyclopedia
Jump to: navigation, search
For other diseases named after Paget, see Paget's disease (disambiguation).
Paget-Schrotter disease
Classification and external resources
Gray576.png
Anterior view of right upper limb and thorax
ICD-10 I82.8
ICD-9 453.8
DiseasesDB 34349
eMedicine med/2772

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.

Signs and symptoms[edit]

The condition is relatively rare.[1] 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,[2] as it has been reported to occur after vigorous activity,[3] though it can also occur spontaneously. It may develop as a sequela of thoracic outlet syndrome. 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.[4]

Symptoms may include sudden onset of pain, warmth, redness, blueness and swelling in the arm. These DVTs rarely cause fatal pulmonary embolism.

Indexing deep vein thrombosis in ICD10 index book gives the code I80.2 which is specific to lower extremeties so the actual code should be I80.8 to clarifiy it is another site.

Treatment[edit]

The traditional treatment for thrombosis is the same as for a lower extremity DVT, and involves anticoagulation with heparin (generally low molecular weight heparin) with a transition to warfarin.

Alternative treatment is thrombolysis to open up the vein, which aims to reduce the incidence of post-thrombotic syndrome, followed by first-rib resection during the same hospital admission and not waiting for a repeat episode.

History[edit]

The condition is named after two men. James Paget[5] first proposed the idea of venous thrombosis causing upper extremity pain and swelling,[6] and Leopold von Schrötter later linked the clinical syndrome to thrombosis of the axillary and subclavian veins.[7]

References[edit]

  1. ^ Hughes, ES (1949). "Venous obstruction in the upper extremity; Paget–Schroetter's syndrome; a review of 320 cases". Surg Gynecol Obstet 88 (2): 89–127. PMID 18108679. 
  2. ^ Drapanas, T; Curran, WL (1966). "Thrombectomy in the treatment of "effort" thrombosis of the axillary and subclavian veins". Journal of Trauma (6): 107. 
  3. ^ Flinterman LE; Van Der Meer FJ; Rosendaal FR; Doggen CJ (Aug 2008). "Current perspective of venous thrombosis in the upper extremity". Journal of Thrombosis and Haemostasis 6 (8): 1262–6. doi:10.1111/j.1538-7836.2008.03017.x. PMID 18485082. 
  4. ^ Reina, Nick J.; Honet, Joseph C.; Brown, William; Beitman, Max; Chodoroff, Gary (1988). "Paget-Schroetter syndrome in a viola player". Medical Problems of Performing Artists 3 (1): 24. 
  5. ^ Paget-von Schrötter disease at Who Named It?
  6. ^ Paget J (1866). "On gouty and some other forms of phlebitis". St. Bartholomew's Hospital Reports 2: 82–92. 
  7. ^ 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.

External links[edit]