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Pulmonary embolism in adolescents.

D Bernstein, S Coupey, S K Schonberg

American Journal of Diseases of Children (1960)

|July 1, 1986

Summary

Pulmonary embolism (PE) is uncommon in adolescents, affecting 78 per 100,000. Risk factors include oral contraceptives in females and trauma in males, with PE rarely being fatal in this age group.

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Area of Science:

Adolescent Medicine
Cardiology
Pulmonology

Background:

Pulmonary embolism (PE) is a significant cause of morbidity and mortality in adults.
The epidemiology and risk factors for PE in adolescents are not well-established.
Adolescent PE may present differently and have a different prognosis than in adults.

Purpose of the Study:

To determine the incidence and epidemiology of PE in hospitalized adolescents.
To identify common clinical presentations and risk factors for PE in this population.
To compare the outcomes of PE in adolescents to those reported in adult populations.

Main Methods:

Retrospective analysis of adolescent admissions over a 15-year period.
Inclusion criteria: patients aged 10-19 years with confirmed PE.
Data collected on demographics, clinical presentation, diagnostic findings, risk factors, and outcomes.

Main Results:

An incidence of 78 PE episodes per 100,000 adolescent admissions was observed.
Female patients outnumbered males 2:1.
Common symptoms included chest pain, dyspnea, cough, and hemoptysis; hypoxemia and deep vein thrombosis were common findings.
Key risk factors were oral contraceptive use/elective abortion in females (75%) and trauma in males (67%).
PE was rarely fatal in adolescents.
High rates of overdiagnosis and underdiagnosis were noted.

Conclusions:

Pulmonary embolism in adolescents is rare but carries distinct risk factors and a generally favorable prognosis compared to adults.
Clinical presentation is similar to adults, but diagnostic challenges (over/underdiagnosis) are prevalent.
Early consideration of pulmonary arteriography is recommended for difficult diagnostic cases in adolescents.

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