Deep vein thrombosis, pulmonary embolism, and the white clot syndrome

Non-Cardiac Conditions that Mimic Cardiac Symptoms in Athletes

When considering the variety of complaints an athlete can present with, chest pain is arguably the most concerning given the potential for catastrophic outcomes. Luckily, these do not comprise the majority of cases, and indeed, are quite rare. The bulk of presentations of athletes with chest pain are due to musculoskeletal, gastrointestinal, and pulmonary causes. Each and every healthcare provider who works closely with athletes must have a thorough understanding of contributing conditions that present as chest pain. Here, we explore some of the more prevalent causes of non-cardiac chest pain, classic presentations, and management considerations.

Pulmonary Embolism in an Adolescent Soccer Player

Pulmonary emboli are potentially life threatening and are rare in the young, healthy, athletic population. We describe the presentation of pulmonary emboli in an otherwise healthy athlete; this has not been reported previously in the literature. A 16-yr-old male soccer player with no apparent risk factors presented in distress with bilateral pulmonary emboli. An extensive workup did not reveal a cause for this phenomenon. The patient was anticoagulated, and a Greenfield inferior vena cava filter was placed because of recurrent symptoms and poor compliance with anticoagulation. This case report illustrates the importance of considering pulmonary embolism as a diagnosis in athletes who present with sudden onset of dyspnea with no discernable cause. Greenfield filter placement in the management of these cases remains controversial.

Dural Sinus Thrombosis Complicated with Heparin Induced Thrombocytopenia and Thrombosis (HITT)

SUMMARY

A case of dural sinus thrombosis complicated with heparin induced thrombocytopenia and thrombosis (HITT) is presented. Interventional neuroradiologic procedures have potential risks of this devastating complication that is related with heparin. Clinical features and pathophysiologic mechanisms of HITT are discussed.

Pulmonary embolectomy in a child

We report the case of a 14-year-old boy treated successfully by pulmonary embolectomy for massive pulmonary embolism, 18 days after bilateral hip surgery. He has a family history of pulmonary embolism and an inherited antithrombin deficiency. His diagnosis was confirmed by spiral computed tomography scan. We believe that pulmonary embolectomy has a role in selected cases in children.