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• W2003021128 abstract "Deep venous thrombosis with pulmonary embolus is a rare complication of oral contraceptives, which generally occurs in adult women and becomes more common with increasing age. These complications are believed to be less common with low dose oral contraceptives than with the higher dose forms. This is a case report of a deep venous thrombosis presenting with a life-threatening pulmonary embolus in an adolescent on low dose triphasic oral contraceptives.A 16 year old teenager with chest pain came to the emergency room at Children's Hospital in Charleston, South Carolina. Her sharp, constant midsternal pain and breathing difficulties began the morning of admission. 1 week before admission, she experienced a similar but less intense pain which resolved spontaneously. She was taking low-dose, triphasic oral contraceptives (OCs) as treatment for severe dysmenorrhea and dysfunctional uterine bleeding. She had no family history of elevated lipids, blood or clotting disorders, and cardiovascular disease. She did not smoke. She was obese (137.3 kg). She had elevated blood pressure (147/33 mm Hg), a high low-density lipoprotein count (140 mg/dL), and a high total cholesterol count (237 mg/dL). Her tender right calf was larger than the left calf. She had decreased perfusion of the entire left lung and right lower lobe. A pulmonary angiogram revealed emboli, and ultrasound of the legs revealed a thrombus behind the right knee. The physicians discontinued the OCs. They administered 2 anticoagulants--intravenous heparin followed by oral sodium warfarin for 6 months. Her respiratory distress ended within several days. Her right calf was no longer tender after 1 week. The physicians discharged her on a low-cholesterol, low-fat diet. They suggested she reduce her weight and exercise more often. She did not experience another venous thrombosis or pulmonary embolus. It appeared that the OCs contributed to her thromboembolism; yet, she did lead a sedentary lifestyle and was considerably overweight. Even though thromboembolism is rare in adolescents with no underlying predisposition for cardiovascular disease and who do not smoke, physicians should watch for sizeable changes in blood pressure, lipids, and cholesterol level as well as symptoms of deep venous thrombosis and cardiovascular disease." @default.
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• W2003021128 date "1992-12-01" @default.
• W2003021128 modified "2023-09-23" @default.
• W2003021128 title "Pulmonary embolus in an adolescent on oral contraceptives" @default.
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• W2003021128 doi "https://doi.org/10.1016/1054-139x(92)90069-n" @default.
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