Healthcare providers may delay or miss blood clot diagnoses, including deep vein thrombosis (DVT) and pulmonary embolism (PE), among athletes who exhibit classic symptoms.Why?Because healthcare providers often do not consider blood clots something that affects athletes. Blood clots are uncommon in young, healthy individuals – and most athletes are young and healthy. So, for that reason, DVT, PE, and arterial clots in athletes are not the norm. Show To understand how this problem affects athletes and the health professionals who treat athletes, you must first understand blood clot terminology. Your body is composed of an endless tunnel of arteries and veins through which blood flows throughout the body. Arteries are the blood vessels that carry the blood from the heart into the outside of the body: the brain, the internal organs, the legs, and the arms. Clots in an arteries lead to stroke, heart attack, or limb-threatening peripheral arterial clots, causing a painful, cold, and pale arm or leg. Many people think of blood clots as a problem that occurs in elderly people and not in young and apparently healthy individuals. Symptoms may, therefore, be misinterpreted as something less serious. Especially in athletes, healthcare providers often interpret the leg symptoms from DVTs as “muscle tear,” a “Charlie horse,” a “twisted ankle,” or shin splints. Chest symptoms from PE are often attributed to a pulled muscle, costochondritis (inflammation of the joint between ribs and breast bone), bronchitis, asthma, or a “touch of pneumonia.” Veins carry blood back to the heart from the rest of your body. Clots in the deep veins of the legs, arms, pelvis, abdomen, or around the brain are called deep vein thrombosis (DVT). If a piece of the clot breaks off from a leg or arm and travels to the lung, it can cause a clot in the lung. A clot in the lung is called a Pulmonary Embolism or PE. A PE can be a life threatening medical emergency. You need to seek immediate medical attention if you have symptoms of a PE. Athlete-Specific Risk Factors for ClotsBeing apparently healthy and being an athlete does not prevent a person from developing blood clots. Several circumstances put the athlete, as well as the non-athlete, at increased risk for DVT and PE. Athletes, coaches, and trainers should be particularly aware of these risk factors.
Time Out: Recent Studies Show Important TrendsTwo studies have evaluated the risk for blood clots associated with marathon or endurance athletes. These studies, conducted by Claire Hull, PhD, and her colleagues in the United Kingdom, appear below. Hull and Harris (2013)_Circulation (2) Hull et al. (2014)_Scand J SMS Go on Offense: Know the Risk Factors for DVT and PE in AthletesThe most common clots occurring in athletes are DVTs of the leg and PE. In addition to the potential risk factors for athletes and non-athletes outlined above, there exist a few unique risk factors that predispose younger people and athletes to DVT and PE:
Get Your Head in the Game: Recognize Blood Clot SymptomsIt’s important to remain vigilant about the signs and symptoms of blood clots. These include:Deep Vein Thrombosis – DVT
Pulmonary Embolism – PE
Treatment ConsiderationsTreatment decisions for people who have blood clots must be individualized. This is particularly true for young, apparently healthy individuals, such as athletes. In the case of unexplained DVT, testing for an inherited or acquired clotting disorder may be appropriate. Read more about blood clot treatment options here. Defense Wins Games: How to Prevent Blood Clots
The Clotting ProcessYour body is designed with a natural balance between factors in your blood that cause your blood to clot and other factors that cause your blood to dissolve clots.Blood clots can occur when:
Unfortunately, few studies exist that investigate the influence of physical training on blood clot formation and dissolution. So, we don’t know the exact net effect of training on this clotting balance mechanism. We do know, for example, that blood levels of the clotting protein Factor VIII increase with exercise and that the elevation persists during recovery. Theoretically, this could lead to an increased risk of blood clots in athletes. However, data also indicate that the fibrinolytic system that dissolves blood clots is overactive in people who exercise. With this over activity, athletes would be protected from having a blood clot. Yet, we do not know the net effect of these changes in athletes. (You can find a detailed scientific discussion of the coagulation issues relevant to exercise and training in a published review listed as reference 1 below. However, the conclusions are sparse and vague, because of a lack of data and conflicting results from different studies.) Psychosocial ImplicationsAthletes need to appreciate that significant deconditioning can occur after a DVT or PE. Depression can also set in after such a life-changing event. This is not surprising, given that athletes often view themselves as healthy and, from a health point of view, invincible, and now suddenly realize that they are vulnerable, sick, and sometimes even disabled. Patient support groups, such as Team Stop The Clot® Facebook Group, may be helpful in this situation, as may antidepressants. Selected References for the above article:
Additional Resources for Athletes
Read Stories of Athletes who have had Blood Clots
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Follow us on TwitterThe United Airlines #NYCHalfMarathon returns to the streets of NYC on March 19, 2023 with @StopTheClot as an official #charitypartner! Applications are now being accepted, but hurry! Only 3 bibs remaining: https://bit.ly/nychalfnbca #charityrun #nyrr #unitednychalf #nychalf Load More... What complication is the nurse aware of that is associated with DVT?What are the complications of a DVT? The biggest problem we worry about with a DVT is that the clot will dislodge (go from being a thrombus to being an embolus) and block vessels in the lung, becoming a pulmonary embolism (also called a PE). IVC filters may be used to prevent a pulmonary embolism from occurring.
Which diagnostic study is used to detect deep vein thrombosis in the clients lower extremities?Venography. The gold standard for establishing the diagnosis of deep vein thrombosis has been contrast venography.
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