A 73-year-old, slightly obese woman arrived at Chicago’s O’Hare International Airport after a long nonstop flight from Tokyo, Japan. She had been confined to a coach seat between 2 moderately overweight passengers and as a result was immobilized in a cramped space for a prolonged period of time. While going through customs, she noted a heaviness and soreness in the calf of her right leg and because the symptoms were mild she dismissed them as a possible bruise. That evening she was concerned when she developed a persistent nonproductive cough. On the advice of her family she went to the nearest emergency department, where alert personnel made an early presumptive diagnosis of venous thromboembolism (VTE).
The frequency of VTE has increased in the general population as a result of longevity and the long hours of air flight by a greater number of travelers. VTE is often a clinically silent disease...