Venous Thromboembolism and Marathon Athletes
Venous thromboembolism (VTE) is the collective term for deep vein thrombosis and pulmonary embolism, both of which constitute globally significant public health burdens. Because awareness of VTE is key to its prevention,1 efforts to disseminate advisory and educational information among medical professionals and the population at large, with specific resources for at-risk groups, remain crucial.
VTE in Athletes: The Need for Heightened Awareness
The benefits of moderate and regular exercise for the general adult population are indisputable. However, for the marathon athlete who trains intensively and for long periods of time, several thrombogenic (causing or resulting in thrombosis) risk factors exist (see Table 1).
Why Are Athletes at Risk of VTE?
In 1884, Rudolph Virchow proposed that risk of VTE could be grouped using a triad related to (1) the efficiency of blood flow, (2) the integrity of blood vessels, and (3) the physical composition of blood itself (Figure).
How Can Athletes Reduce the Likelihood of Deep Vein Thrombosis and Pulmonary Embolism?
Preventive measures to reduce the likelihood of deep vein thrombosis and pulmonary embolism in athletes are much the same as those recognized for the adult population as a whole.1–3 However, in view of the general lack of awareness about the risk of VTE in marathon runners (including among athletes themselves), specific awareness and advisory points are also necessary4,5 (see Table 2). Signs and symptoms that the marathon athlete should be aware of are given in Table 3, and diagnostic considerations for the medical practitioner are given in Table 4.
Return to Training
Because it is usual for athletes to follow specific training routines when injured and because adherence to prescribed targets can help rationalize the anxiety associated with rehabilitation, the guidelines given in Table 5 for marathon athletes are useful.
National Blood Clot Alliance (NBCA). Stop the Clot. http://www.stoptheclot.org/News/article126.htm. Accessed June 2013.
The information contained in this Circulation Cardiology Patient Page is not a substitute for medical advice, and the American Heart Association recommends consultation with your doctor or healthcare professional.
- © 2013 American Heart Association, Inc.
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