Document Detail


Pulmonary embolism as a cause of a reduced performance capacity of endurance trained men - report of 2 cases
MedLine Citation:
PMID:  20717863     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
HISTORY AND ADMISSION FINDINGS: Two trained long-distance runners, aged 53 and 58 years, respectively, presented (independently) at our outpatient department because of an acute reduction in physical performance after considerable exertion. Neither had specific clinical symptoms, particularly no dyspnea. INVESTIGATIONS: Neither patient had abnormal findings on physical examination, such as signs for deep venous thrombosis. The electrocardiogram and echocardiography were normal. Exercise tests revealed a significant limitation in physical performance and, in one patient, a reduction in arterial blood oxygen and elevated d-dimers as the only abnormal laboratory test result. DIAGNOSIS, TREATMENT AND COURSE: The diagnosis of pulmonary embolism was made by computed tomography, which showed the typical changes. In both patients venous phlebography revealed deep vein thrombosis and signs of post-thrombotic changes. Laboratory tests were unremarkable, with normal blood coagulation and no factor II mutations. Anticoagulants were administered to each patient and they slowly resumed their training program. At a subsequent examination physical performance had improved, but there was still a reduction in arterial oxygen during exercise. CONCLUSION: Even endurance-trained sportspersons without thrombophilic risk factors may develop deep vein thrombosis. Even when there are no symptoms, pulmonary embolism should always be included in the differential diagnosis of a sudden and significant reduction in physical performance.
Authors:
U Korsten-Reck; J Winterer; D König; Hans-Hermann Dickhuth
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Publication Detail:
Type:  English Abstract; Journal Article     Date:  2010-08-17
Journal Detail:
Title:  Deutsche medizinische Wochenschrift (1946)     Volume:  135     ISSN:  1439-4413     ISO Abbreviation:  Dtsch. Med. Wochenschr.     Publication Date:  2010 Aug 
Date Detail:
Created Date:  2010-08-18     Completed Date:  2010-09-15     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0006723     Medline TA:  Dtsch Med Wochenschr     Country:  Germany    
Other Details:
Languages:  ger     Pagination:  1596-600     Citation Subset:  IM    
Copyright Information:
Georg Thieme Verlag KG Stuttgart * New York.
Affiliation:
Medizinische Klinik, Abt. Präventive und Rehabilitative Sportmedizin, Universität Freiburg, Freiburg.
Vernacular Title:
Lungenembolie als Ursache einer Leistungsminderung bei Ausdauersportlern - 2 Kasuistiken.
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MeSH Terms
Descriptor/Qualifier:
Acute Disease
Angiography
Anticoagulants / therapeutic use
Athletic Performance / physiology*
Diagnosis, Differential
Electrocardiography
Enoxaparin / therapeutic use
Exercise Test
Fibrin Fibrinogen Degradation Products / metabolism
Follow-Up Studies
Humans
Male
Middle Aged
Oxygen / blood
Phenprocoumon / therapeutic use
Physical Endurance / physiology*
Pulmonary Embolism / diagnosis*,  drug therapy,  physiopathology
Running / physiology*
Tomography, X-Ray Computed
Venous Thrombosis / diagnosis,  drug therapy,  physiopathology
Chemical
Reg. No./Substance:
0/Anticoagulants; 0/Enoxaparin; 0/Fibrin Fibrinogen Degradation Products; 0/fibrin fragment D; 435-97-2/Phenprocoumon; 7782-44-7/Oxygen

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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