The fact that athletes are constantly on the move and physically active should indicate that certain medical conditions, including deep vein thrombosis, should not be considered common among them. However, the opposite effect is often observed. We hear of young and healthy athletes suffering various accidents and life-threatening complications – some unexplained, some obvious, and some the result of multiple factors leading to conditions such as thrombosis. Why is this the case?

What is deep vein thrombosis?

Deep vein thrombosis (DVT) is a condition in which a blood clot forms in the deep veins, typically in the legs, but also in the mesenteric and cerebral veins. It occurs due to reduced blood flow, increased venous pressure, mechanical injury to the vein and increased blood viscosity. In addition, coagulation factors are involved in the development of the disease, which can be hereditary (e.g. lack of anticoagulant proteins C and S, antithrombin III or factor V Leiden mutation) or acquired (such as cancers, heart attack, inflammatory bowel disease, nephrotic syndrome, burns, oral estrogens, smoking, hypertension, and diabetes).

The primary mechanisms that contribute to clot formation in deep vein thrombosis include damage to blood vessels, turbulence in blood flow, and hypercoagulability. Thrombosis functions as a protective response to prevent blood loss when a blood vessel is injured, while fibrinolysis serves to prevent or stabilize thrombosis, thereby avoiding excessive clot formation. It is evident that the successful formation of a clot hinges on the balance between thrombosis and fibrinolysis.

Symptoms indicative of deep vein thrombosis (DVT) may include swelling in the legs, pain in the lower extremities, skin discolouration, and a sensation of warmth in the affected area. The most serious complication of DVT is pulmonary embolism, which occurs when a clot formed in the leg or arm dislodges and travels to the lungs, obstructing blood flow. This condition can reduce oxygen levels in the lungs and elevate blood pressure in the pulmonary arteries. Pulmonary embolism necessitates immediate medical intervention, as it can result in damage to the heart or lungs and may often be fatal. Alarmingly, approximately 33% of individuals with pulmonary embolism succumb before receiving a diagnosis and appropriate treatment.

What happens in the veins of athletes?

Deep vein thrombosis is typically not regarded as a common condition among otherwise healthy individuals or young athletes. However, it has been documented that some elite professional athletes have received diagnoses of this ailment, which has not only curtailed their competitive careers but also posed significant health risks due to potentially life-threatening outcomes. This illustrates that attributes such as fitness, talent, and vitality do not serve as reliable protective factors for everyone concerning deep vein thrombosis and the associated thromboembolism.

So why do young athletes suffer from this condition? It could be due to spending long periods sitting still in cars or airplanes while traveling to various sporting events. Other contributing factors include dehydration, various traumas such as broken bones, and immobilization. In women, it can also occur due to the use of oral contraceptives, pregnancy, or hormone replacement therapy. Furthermore, both hereditary and acquired clotting disorders play a role in its development.

How to prevent the development of dangerous complications?

Athletes themselves can influence this by taking breaks and stretching their legs when traveling long distances, staying well-hydrated during and after strenuous sports events and travel, and being aware of the risk factors for blood clots. It is advisable for them to inquire if anyone in their family has a history of blood clotting disorders. In the case of major surgery, trauma, prolonged immobility, or when a cast is required, they should consult their doctor about a plan for preventing blood clots. It is also crucial to recognize the symptoms and seek medical help if they arise.

Translated by: Josip Kokanović

Literature

1. Athletes: At Risk for Deep Vein Thrombosis, 2019., https://www.uclahealth.org/, accessed: 24. 1. 2025.

2. Hummel C et al. Posttraumatic Deep Vein Thrombosis in Collegiate Athletes: An Exploration Clinical Case Series. J Athl Train. 2018, 53(5), 497-502.

3. Athletes and Blood Clots, https://www.stoptheclot.org/, accessed: 24. 1. 2025.

4. Waheed SM, Kudaravalli P, Hotwagner DT. Deep Vein Thrombosis. StatPearls Treasure Island (FL): StatPearls, 2025.

5. Pulmonary Embolism, 2024., https://my.clevelandclinic.org/, accessed: 24. 1. 2025.

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