Musculoskeletal Medicine and PainCASE REPORT

Chronic exertional compartment syndrome in a patient with restrictive cardiomyopathy and portal hypertension

Christopher Lu, MD; Min Yoo, MD, MSCR; and Arthur J. De Luigi, DO, MHA
Notes and Affiliations
Notes and Affiliations

Received: March 22, 2022

Accepted: August 17, 2022

Published: September 14, 2022

  • Christopher Lu, MD, 

    Montefiore Medical Center, Department of Physical Medicine & Rehabilitation, Bronx, NY, USA

  • Min Yoo, MD, MSCR, 

    Spine Care and Department of Physical Medicine & Rehabilitation, Mayo Clinic Arizona, Phoenix, AZ, USA

  • Arthur J. De Luigi, DO, MHA, 

    Spine Care, Sports Medicine, and Department of Physical Medicine & Rehabilitation, Mayo Clinic Arizona, Phoenix, AZ, USA

J Osteopath Med; 122(12): 631-634
Abstract

Chronic exertional compartment syndrome (CECS) is a condition that produces exercise-induced pain and swelling due to a transient increase in compartment pressures. It is thought to be due to muscle hypertrophy and is classically associated with young athletes under 30, overtraining, anabolic steroid use, and aberrant running biomechanics. We present a unique case of CECS in a patient without the traditional risk factors but rather diagnosed with cardiac cirrhosis and portal hypertension. This patient’s exercise-induced bilateral leg pain met the CECS criteria for leg compartment pressure testing and was attributed to fluid retention secondary to his comorbidities. His symptoms significantly improved after initiating diuretic pharmacotherapy. Based on our literature review, there is a dearth of literature associating CECS with specific chronic cardiac or hepatic conditions as well as describing its incidence in these conditions.

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