Paget-Schroetter disease pathophysiology: Difference between revisions

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==Overview==
==Overview==
The exact pathogenesis of [disease name] is not fully understood.


OR


It is thought that [disease name] is the result of / is mediated by / is produced by / is caused by either [hypothesis 1], [hypothesis 2], or [hypothesis 3].


OR
It is though that Paget-Schroetter disease (ie, Effort Thrombosis) is a form of Subclavian vein thrombosis resulted from Subclavian compression. This condition is more common in athletes and/or manual labors. Some studies link Paget-Schroetter disease with anatomical defects involving the thoracic outlet.


[Pathogen name] is usually transmitted via the [transmission route] route to the human host.


OR


Following transmission/ingestion, the [pathogen] uses the [entry site] to invade the [cell name] cell.


OR




[Disease or malignancy name] arises from [cell name]s, which are [cell type] cells that are normally involved in [function of cells].


OR
The progression to [disease name] usually involves the [molecular pathway].
OR
The pathophysiology of [disease/malignancy] depends on the histological subtype.


==Pathophysiology==
==Pathophysiology==
===Physiology===
===Physiology===
The normal physiology of [name of process] can be understood as follows:
The Subclavian vein passes through a space surrounded by the first rib, the Scalenus anterior muscle and the Subclavius muscle and tendon.<ref name="pmid24459553">{{cite journal| author=Mall NA, Van Thiel GS, Heard WM, Paletta GA, Bush-Joseph C, Bach BR| title=Paget-schroetter syndrome: a review of effort thrombosis of the upper extremity from a sports medicine perspective. | journal=Sports Health | year= 2013 | volume= 5 | issue= 4 | pages= 353-6 | pmid=24459553 | doi=10.1177/1941738112470911 | pmc=3899898 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24459553  }}</ref>
 
<br />


===Pathogenesis===
===Pathogenesis===
*The exact pathogenesis of [disease name] is not completely understood.
It is though that Paget-Schroetter disease (ie, Effort Thrombosis) is the result of Subclavian vein compression and subsequent thrombosis, and is more common in athletes and/or manual labors. Sports related to higher chance for this condition are baseball, softball, wrestling, playing ball, gymnastic, swimming, hockey, martial arts, backpacking and billiards which require repetitive and constant upper extremity activities. <ref name="pmid244595532">{{cite journal| author=Mall NA, Van Thiel GS, Heard WM, Paletta GA, Bush-Joseph C, Bach BR| title=Paget-schroetter syndrome: a review of effort thrombosis of the upper extremity from a sports medicine perspective. | journal=Sports Health | year= 2013 | volume= 5 | issue= 4 | pages= 353-6 | pmid=24459553 | doi=10.1177/1941738112470911 | pmc=3899898 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24459553  }}</ref> Even with normal anatomical structure the Subclavian vein can be compressed through hyper-abduction (more prominent in arm abducted over 90 degrees), extension and/or external rotation.<ref name="pmid210797092">{{cite journal| author=Alla VM, Natarajan N, Kaushik M, Warrier R, Nair CK| title=Paget-schroetter syndrome: review of pathogenesis and treatment of effort thrombosis. | journal=West J Emerg Med | year= 2010 | volume= 11 | issue= 4 | pages= 358-62 | pmid=21079709 | doi= | pmc=2967689 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21079709  }}</ref>{{cite web|url=https://www.sciencedirect.com/science/article/pii/S074152140902518X#fig3|title=A comprehensive review of Paget-Schroetter syndrome - ScienceDirect|format=|work=|accessdate=}} Furthermore compression could be seen in hypertrophied Scalenus anterior or Subclavius muscle. In addition to compression, these activities can put tension on the Subclavian vein which lead to micro-trauma of the endothelium and initiate the coagulation cascade.<ref name="pmid210797093">{{cite journal| author=Alla VM, Natarajan N, Kaushik M, Warrier R, Nair CK| title=Paget-schroetter syndrome: review of pathogenesis and treatment of effort thrombosis. | journal=West J Emerg Med | year= 2010 | volume= 11 | issue= 4 | pages= 358-62 | pmid=21079709 | doi= | pmc=2967689 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21079709  }}</ref> Increased bulk of muscles like Pectoralis minor and Subscapularis muscles and presence of Osseous Exostoses or fibrous bands, as well as congenital or post-trauma bone deformities can cause further compression.<ref name="pmid244595533">{{cite journal| author=Mall NA, Van Thiel GS, Heard WM, Paletta GA, Bush-Joseph C, Bach BR| title=Paget-schroetter syndrome: a review of effort thrombosis of the upper extremity from a sports medicine perspective. | journal=Sports Health | year= 2013 | volume= 5 | issue= 4 | pages= 353-6 | pmid=24459553 | doi=10.1177/1941738112470911 | pmc=3899898 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24459553  }}</ref>
OR
 
*It is understood that [disease name] is the result of / is mediated by / is produced by / is caused by either [hypothesis 1], [hypothesis 2], or [hypothesis 3].
*
*[Pathogen name] is usually transmitted via the [transmission route] route to the human host.
*Following transmission/ingestion, the [pathogen] uses the [entry site] to invade the [cell name] cell.
*[Disease or malignancy name] arises from [cell name]s, which are [cell type] cells that are normally involved in [function of cells].
*The progression to [disease name] usually involves the [molecular pathway].
*The pathophysiology of [disease/malignancy] depends on the histological subtype.


==Genetics==
==Genetics==

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:

Overview

It is though that Paget-Schroetter disease (ie, Effort Thrombosis) is a form of Subclavian vein thrombosis resulted from Subclavian compression. This condition is more common in athletes and/or manual labors. Some studies link Paget-Schroetter disease with anatomical defects involving the thoracic outlet.





Pathophysiology

Physiology

The Subclavian vein passes through a space surrounded by the first rib, the Scalenus anterior muscle and the Subclavius muscle and tendon.[1]


Pathogenesis

It is though that Paget-Schroetter disease (ie, Effort Thrombosis) is the result of Subclavian vein compression and subsequent thrombosis, and is more common in athletes and/or manual labors. Sports related to higher chance for this condition are baseball, softball, wrestling, playing ball, gymnastic, swimming, hockey, martial arts, backpacking and billiards which require repetitive and constant upper extremity activities. [2] Even with normal anatomical structure the Subclavian vein can be compressed through hyper-abduction (more prominent in arm abducted over 90 degrees), extension and/or external rotation.[3]"A comprehensive review of Paget-Schroetter syndrome - ScienceDirect". Furthermore compression could be seen in hypertrophied Scalenus anterior or Subclavius muscle. In addition to compression, these activities can put tension on the Subclavian vein which lead to micro-trauma of the endothelium and initiate the coagulation cascade.[4] Increased bulk of muscles like Pectoralis minor and Subscapularis muscles and presence of Osseous Exostoses or fibrous bands, as well as congenital or post-trauma bone deformities can cause further compression.[5]

Genetics

[Disease name] is transmitted in [mode of genetic transmission] pattern.

OR

Genes involved in the pathogenesis of [disease name] include:

  • [Gene1]
  • [Gene2]
  • [Gene3]

OR

The development of [disease name] is the result of multiple genetic mutations such as:

  • [Mutation 1]
  • [Mutation 2]
  • [Mutation 3]

Associated Conditions

Conditions associated with [disease name] include:

  • [Condition 1]
  • [Condition 2]
  • [Condition 3]

Gross Pathology

On gross pathology, [feature1], [feature2], and [feature3] are characteristic findings of [disease name].

Microscopic Pathology

On microscopic histopathological analysis, [feature1], [feature2], and [feature3] are characteristic findings of [disease name].

References

  1. ↑ Mall NA, Van Thiel GS, Heard WM, Paletta GA, Bush-Joseph C, Bach BR (2013). "Paget-schroetter syndrome: a review of effort thrombosis of the upper extremity from a sports medicine perspective". Sports Health. 5 (4): 353–6. doi:10.1177/1941738112470911. PMC 3899898. PMID 24459553.
  2. ↑ Mall NA, Van Thiel GS, Heard WM, Paletta GA, Bush-Joseph C, Bach BR (2013). "Paget-schroetter syndrome: a review of effort thrombosis of the upper extremity from a sports medicine perspective". Sports Health. 5 (4): 353–6. doi:10.1177/1941738112470911. PMC 3899898. PMID 24459553.
  3. ↑ Alla VM, Natarajan N, Kaushik M, Warrier R, Nair CK (2010). "Paget-schroetter syndrome: review of pathogenesis and treatment of effort thrombosis". West J Emerg Med. 11 (4): 358–62. PMC 2967689. PMID 21079709.
  4. ↑ Alla VM, Natarajan N, Kaushik M, Warrier R, Nair CK (2010). "Paget-schroetter syndrome: review of pathogenesis and treatment of effort thrombosis". West J Emerg Med. 11 (4): 358–62. PMC 2967689. PMID 21079709.
  5. ↑ Mall NA, Van Thiel GS, Heard WM, Paletta GA, Bush-Joseph C, Bach BR (2013). "Paget-schroetter syndrome: a review of effort thrombosis of the upper extremity from a sports medicine perspective". Sports Health. 5 (4): 353–6. doi:10.1177/1941738112470911. PMC 3899898. PMID 24459553.

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