Deep Venous Thrombosis and Pulmonary Thromboembolism in a Physically Nonprepared Trekker in the Himalayas: An Autopsy Report
International Journal of Medical Toxicology and Forensic Medicine,
Vol. 11 No. 4 (2021),
17 Aban 2021
,
Page 34555
https://doi.org/10.32598/ijmtfm.v11i4.34555
Abstract
Deep Venous Thrombosis (DVT) and Subsequent Pulmonary Thromboembolism (PTE) in high altitude climbers is a well-known concept. The acclimatization process at high altitude is itself a thrombogenic event. Accordingly, when a physically nonprepared individual with preexisting thrombogenic risk factors attempts trekking at high altitude, they may end up with fatal thromboembolic events. Here, we report a case of a low-lander with multiple thrombogenic risk factors who developed DVT and PTE when he went for a trekking trip in the Himalayas. The risk factors, autopsy findings, and possible mechanism of developing fatal pulmonary embolism, in this case, are discussed here.
- High altitude
- Deep vein thrombosis
- Pulmonary thromboembolism
- Hypoxia
- Virchow’s triad
How to Cite
References
Hull CM, Rajendran D, Fernandez Barnes A. Deep vein thrombosis and pulmonary embolism in a mountain guide: Awareness, diagnostic challenges, and management considerations at altitude. Wilderness Environ Med. 2016; 27(1):100-6. [DOI:10.1016/j.wem.2015.10.010] [PMID]
Pandey P, Lohani B, Murphy H. Pulmonary embolism masquerading as high altitude pulmonary edema at high altitude. High Alt Med Biol. 2016; 17(4):353-8. [DOI:10.1089/ham.2016.0008] [PMID] [PMCID]
Obrowski M, Obrowski S. Deadly High Altitude Pulmonary Disorders: Acute Mountain Sickness (AMS); High Altitude Pulmonary Edema (HAPE) and High Altitude Cerebral Edema (HACE): A Clinical Review. Int J Pul Res Sci. 2016; 1(1):555553. [DOI:10.19080/IJOPRS.2016.01.555553]
Heit JA, Silverstein MD, Mohr DN, Petterson TM, O’Fallon WM, Melton LJ 3rd. Risk factors for deep vein thrombosis and pulmonary embolism: A population-based case-control study. Arch Intern Med. 2000; 160(6):809-15. [DOI:10.1001/archinte.160.6.809] [PMID]
Latshang TD, Bloch KE, Lynm C, Livingston EH. JAMA patient page. Traveling to high altitude when you have sleep apnea. JAMA. 2012; 308(22):2418. [DOI:10.1001/jama.2012.4097] [PMID]
Srivastava S. Travelling to high altitudes could be thrombogenetic!. Arch Pulmonol Respir Care. 2015; 1(1):023-7. [DOI:10.17352/aprc.000006]
Kumar S. High altitude induced deep venous thrombosis: A study of 28 cases. Indian J Surg. 2006; 68:84-8. http://hdl.handle.net/1807/6394
Segler CP. Prophylaxis of climbers for prevention of embolic accidents. Med Hypotheses. 2001; 57(4):472-5. [DOI:10.1054/mehy.2001.1367] [PMID]
Gupta N, Ashraf MZ. Exposure to high altitude: A risk factor for venous thromboembolism? Semin Thromb Hemost. 2012; 38(2):156-63. [DOI:10.1055/s-0032-1301413] [PMID]
Austin AW, Wissmann T, von Kanel R. Stress and hemostasis: An Update. Semin Thromb Hemost. 2013; 39(8):902-12. [DOI:10.1055/s-0033-1357487] [PMID]
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