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Pulmonary embolism in adolescents.
Qing-bian Ma1, Wan-zhen Yao, Jian-ming Chen
1Department of Emergency Medicine, Peking University Third Hospital, Beijing 100191, China.
Chinese Medical Journal
|May 23, 2012
Summary
Pulmonary embolism (PE) is a rare but serious condition in adolescents, often diagnosed late due to physician oversight. Early consideration of PE in adolescents with symptoms like chest pain and risk factors is crucial for timely diagnosis.
Area of Science:
- Cardiology
- Pulmonology
- Adolescent Medicine
Background:
- Pulmonary embolism (PE) is an underrecognized, potentially fatal condition in adolescents.
- This study investigates the epidemiology, clinical presentation, and diagnostic delays of PE in this age group.
Purpose of the Study:
- To understand the epidemiology of PE in adolescents.
- To identify clinical features and risk factors associated with PE in adolescents.
- To analyze the causes and duration of diagnostic delays in adolescent PE cases.
Main Methods:
- Retrospective analysis of nine adolescent PE cases over 16 years.
- Comparison of adolescent PE characteristics with adult and elderly populations.
- Assessment of pretest probability using Wells and revised Geneva scores.
Main Results:
- Incidence of PE in hospitalized adolescents was 43.6 per 100,000.
- Adolescent PE presented similarly to adults, with more frequent fever and chest pain.
- Key risk factors included surgery, SLE, thrombocytopenia, glucocorticoids, and trauma.
- Mean diagnostic delay was 11 days, with misdiagnosis common (often respiratory infection).
- Most patients had moderate to high clinical probability scores.
Conclusions:
- PE is frequently overlooked in adolescents, leading to diagnostic delays, particularly in outpatient settings.
- Physicians should consider PE in adolescents presenting with dyspnea, chest pain, or syncope, especially with risk factors.
- Prompt inclusion of PE in the differential diagnosis is essential for this population.
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