Atrial fibrillation and pulmonary embolism

Atrial fibrillation is a rare diagnosis in children and adolescents. We report a case of a 17-year-old previously healthy boy who presented to the emergency department with a 3-week history of shortness of breath, chest pain, and 1 episode of hemoptysis. Symptoms persisted despite a course of antibiotics and anti-inflammatory agents. The patient developed palpitations and was found to be in atrial fibrillation at the time of hospitalization. An extensive workup led to the diagnosis of pulmonary embolism. This case highlights the importance of evaluating for thromboembolic events in pediatric patients presenting with new-onset atrial fibrillation and typical electrocardiogram pattern of cor pulmonale with or without respiratory symptoms.