Pulmonary Embolism in a Female Collegiate Cross-country Runner Presenting as Nonspecific Back Pain
SOURCE: J Chiropractic Medicine 2012 (Sep); 11 (3): 215–220
Warren H. Landesberg, DC, DACBSP
Doctor of Chiropractic, Private Practice,
Briarcliff Manor, NY.
OBJECTIVE: The purpose of this case report is to describe a female athlete with back and right scapular pain due to pulmonary embolism.
CLINICAL FEATURES: A 20-year-old female collegiate cross-country runner presented to a chiropractic clinic with pain in the right scapular area that was severe, stabbing, and worsened with respiration. She had a cough and experienced difficulty lying on her right side. She had an elevated d-dimer. Chest radiograph demonstrated pleural effusion, prompting a thoracic computed tomographic angiogram that showed a large right lower lobe embolus and pulmonary infarct.
INTERVENTION AND OUTCOME: The patient was hospitalized, prescribed anticoagulant therapy, and monitored for 6 months. She was able to return to competitive running 8 months later.
CONCLUSION: This case raises awareness of the occurrence of birth control medication for the purpose of enhanced performance in female athletes and the associated risks of using this medication for enhanced performance.
From the FULL TEXT Article:
Oral contraceptive (OC) use has become more widespread in female athletes. Reports suggest that the use of OCs to enhance performance increased substantially in the 1990s, approaching 50% of female athletes.  This figure is believed to be similar to the percentage of women taking OCs for birth control.  It has been reported that nearly 50% of female team sport athletes and 83% of elite-level athletes used OCs.  Risk factors for thromboembolic disease are believed to be far less among athletes than the general population, but there have been reported cases.  Despite the popularity, there is no conclusive evidence that OC use has any benefit to enhanced athletic performance. 
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