"Effort" thrombosis of the axillary and subclavian vein associated with cervical rib and oral contraceptives in a young woman athlete.

"Effort" thrombosis, also called the Paget-Schroetter syndrome or primary thrombosis of the upper extremity, has been well documented in the literature. However, in our review of the United States, Canadian, and British literature, we found only 52 cases in which it was related to sports participation. We report a case of axillary and subclavian vein "effort" thrombosis in a young woman athlete, who was predisposed to thrombosis by all three postulates of the Virchow triad: namely, (1) stasis caused by constriction from a cervical rib, (2) increased coagulability as a result of oral contraceptive use, and (3) vessel wall injury because of competitive softball participation. Of the available therapeutic plans, we believe that athletes with "effort" thrombosis should have aggressive treatment that is initiated as early as possible to prevent swelling, tingling numbness, easy fatigue of the arm, and pain on prolonged use of the affected extremity.