Volume 29, Issue 163, September 2025

Venous thrombosis in athletes - a literature review

Jakub Ziółkowski^1♦, Natalia Katarzyna Wagner-Bieleń², Martyna Zwierzchowska¹, Agata Antoniak³, Anna Maria Jocz⁴, Anna Centkowska⁵, Joanna Karina Banaśkiewicz⁶, Aleksandra Maria Żyta¹, Gabriela Helena Dąbrowska⁷, Maria Anna Żmijewska⁸

¹Independent Public Clinical Hospital of Prof. W. Orlowski CMKP, ul. Czerniakowska 231, 00-416 Warsaw, Poland
²Military Institute of Medicine - National Research Institute, ul. Szaserów 128, 04-141 Warsaw, Poland
³Praski Hospital of the Transfiguration of the Lord, al. "Solidarności" 67, 03-401 Warsaw, Poland
⁴Specialist Provincial Hospital in Ciechanów, Powstańców Wielkopolskich 2, 06-400 Ciechanów, Poland
⁵Wolski Hospital of Dr. Anna Gostyńska, ul. Marcina Kasprzaka 17, 01-211 Warsaw, Poland
⁶Independent Public Health Care Complex - Hospital in Iłża, ul. Bodzentyńska 17, 27-100 Iłża, Poland
⁷The Infant Jesus Teaching Hospital, ul. Williama Heerleina Lindleya 4, 02-005 Warsaw, Poland
⁸Faculty of Medicine, Medical University of Warsaw, ul. Żwirki i Wigury 61, 02-091 Warsaw, Poland

^♦Corresponding author
Jakub Ziółkowski, Independent Public Clinical Hospital of Prof. W. Orlowski CMKP ul. Czerniakowska 231, 00-416 Warsaw, Poland

ABSTRACT

Venous thromboembolism (VTE) is a health concern with serious morbidity and mortality. While athletes are perceived as healthy with a lower VTE incidence than general population, they are exposed to many unique risk factors. VTE in athletes presents unique diagnostic and therapeutic challenges, what impacts their ability to compete. This review brings together information to explore the understanding of VTE in athletes, focusing on its pathophysiology, diagnosis, management and screening. Sportsmen are exposed to sport-acquired risk factors and may have underlying genetic tendencies disrupting the hemostasis. Diagnosis can be difficult as symptoms mimic common sports injuries. Standard therapy prohibited playing contact sports while on anticoagulation. Invention of direct oral anticoagulants led to individualized, intermittent dosing strategies, which allows competing again while lowering bleeding risk. Patients with personal or family history should be considered for screening. Further research is necessary for treatment optimization strategies and better long-term outcomes. For this paper we performed a thorough search of literature by using databases: PubMed, Medline, and Google Scholar, where "Venous thrombosis in athletes" or "Hypercoagulability in athletes" appeared in the title, abstract, or keywords. Athletes, despite their professional physical shape and their overall good health, face specific risks of VTE, often connected to sports discipline. Keeping these factors in mind, being aware of potential misdiagnosis and its consequences, and the approach heavily relying on individualized treatment are crucial for managing VTE in this population and making a return to play possible, while minimizing risks.

Keywords: athletes, venous thromboembolism, deep vein thrombosis, pulmonary embolism, anticoagulation

Medical Science, 2025, 29, e171ms3708

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DOI: https://doi.org/10.54905/disssi.v29i163.e171ms3708

Published: 21 September 2025