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The Journal of the American Board of Family Practice 18:314-319 (2005)
© 2005 American Board of Family Practice

Brief Report

Paget-Schroetter Syndrome in the Young and Active

Viju Vijaysadan, MD, Aphrodite M. Zimmerman, MS and Rafael E. Pajaro, MD

Department of Medicine, Overlook Hospital, Summit, New Jersey (VV, REP)
Medical School, University of Medicine and Dentistry of New Jersey, Newark (AMZ)

Correspondence: Corresponding author: Viju Vijaysadan, MD, Department of Medicine, Overlook Hospital, 99 Beauvoir Avenue, Summit, NJ 07901 (e-mail: viju{at}earthlink.net)

We report this case of effort thrombosis of the upper extremity (Paget-Schroetter syndrome) caused by hypertrophied muscles. This unusual cause of extrinsic venous compression and intimal injury leading to thrombosis was treated uniquely with good outcome. Untreated symptomatic patients can sustain long-term disability from venous obstruction resulting in significant loss of occupational productivity and quality of life. For the same reason, early catheter directed thrombolysis followed by anticoagulation and surgical intervention are recommended in much of the recent literature. Thrombolysis is the most common form of treatment, followed by surgery, if needed, after careful diagnostic approach. A majority of the literature supports a multimodal approach, but there is no definite consensus on management. This highlights the need for randomized clinical trials to guide management as well as to assess the safety and efficacy of anticoagulants commonly used and to define the optimal duration of therapy after thrombolysis.


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Copyright © 2005 by the American Board of Family Medicine.