HEMOPTYSIS -“EFFORT INDUCED THROMBOSIS”
Journal Title: Stanley Medical Journal - Year 2016, Vol 3, Issue 4
Abstract
A 30 year old male, photographer presented with the complaints of swelling and continuous throbbing pain in the right upper limb on the medial aspect for 2 weeks, cough with haemoptysis 3-4 episodes,each time 3-5 ml in the past 3 days and breathlessness for 3 days MRC grade 2 . On examination , the breath sounds were diminished on right infrascapular and interscapular areas and on percussion stony dull note was seen on same areas. Chest X-Ray PA view showed homogenous peripheral wedge shaped opacities in both lower zones, on both sides . CT chest revealed round wedge shaped opacities with convexity noted bilaterally in posterior basal segments. Patient’s right upper limb Doppler revealed thrombus in the right subclavian vein which extended into the right axillary vein .His coagulation profile was normal .The serum Homocysteine levels were increased to about 50 mmol/l ,other prothrombotic factors being normal .Hence a provisional diagnosis of PAGET SHROTTER SYNDROME,secondary to hyperhomocystinemia,with pulmonary embolism and bilateral pulmonary infarcts was made. This syndrome is also called “EFFORT INDUCED THROMBOSIS” because it has been reported in sports person who does vigorous activity.The patient was anticoagulated with heparin and started on T.Folic acid and discharged with the latter and T.Acenocoumarol 2 mg .Key Messages :Paget shrotter syndrome is a rare condition causing upper limb DVT induced by vigorous effort involving upper limb usually ,can present as pain,swelling of upper limb and may go into complications like pulmonary embolism
Authors and Affiliations
Anu S, Ramalingam A, Ashokkumar .
Keywords
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