Massive Pulmonary Embolism in a High School Wrestler

Philip H. Croyle, MD; Robert A. Place, MD; Alan D. Hilgenberg, MD
JAMA. 1979;241(8):827-828. doi:10.1001/jama.1979.03290340045027.
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DEEP-vein thrombosis is an unusual entity in teenage boys, and pulmonary embolism is rarer still. We report a case of a young athlete in whom both occurred and discuss a possible association with the precompetition weight loss that is commonly practiced in wrestling.

Report of a Case  A 16-year-old high school wrestler weighing 49.5 kg had a flu-like syndrome that included fever, nausea, weakness, and myalgias two days before a match. He lost 3.5 kg to "make weight" for the match and was defeated by an opponent he had handily beaten before. He was dyspneic for 30 minutes after his fall. Four days later he competed again, this time losing 2.5 kg by sweating and restricting fluid intake. He became exhausted in the second period and was pinned; cyanosis was noted, and oxygen was administered. The next day his physician heard a heart murmur, and the patient was transferred to


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