Paget-Schroetter disease history and symptoms

A positive history of repetitive upper extremity movements in a patient presenting with arm discomfort and edema is suggestive of Paget-Schroetter disease.

• A positive history of vigorous upper extremity movements or even relatively minor day-to-day arm activities with or without dehydration in the presence of related symptoms is suggestive of Paget-Schroetter disease.^[1]
• The most common symptoms of Paget-Schroetter disease include arm discomfort or heaviness, pain, swelling, and erythema of the upper extremity.

• Patients with Paget-Schroetter disease or effort thrombosis may have a positive history of:

1. Sports-related arm exertion (often with sports that require repetitive hyper-abduction, extension and/or external rotation)
2. Minor everyday upper limb activities^[2]

• Onset of the Paget-Schroetter disease is usually acute or sub-acute, nevertheless some cases present with chronic symptoms.^[3]
• Around 60-80% of cases with Paget-Schroetter disease have a history of repetitious activity of upper extremity with 85% occurred within last 24 hours of symptoms onset.^[4]
• In 87% of cases, the Paget-Schroetter disease involves the dominant arm.^[5]

Common symptoms of Paget-Schroetter disease include:

• Arm discomfort and heaviness
• Pain
• Edema and swelling
• Erythema of the affected upper limb
• Cyanosis (usually presented in late stages)^[6]
• Paresthesia^[7]

• Occasionally symptoms of Paget-Schroetter disease can mimic a muscular strain.  
• Patients may initially presented with symptoms of Pulmonary Embolism.^[8]

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