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Pediatric pulmonary artery thromboembolism: an illustrative case
R E Goldsby1, A J Saulys, J G Helton
1Department of Pediatric Cardiology, Children's Hospital of Oakland, CA 94609, USA.
Insights
Pulmonary embolism (PE) can be subtle in children. Maintaining a high index of suspicion is crucial for early diagnosis and treatment to reduce mortality.
Area of Science:
- Pediatric Pulmonology
- Diagnostic Imaging
- Critical Care Medicine
Background:
- Pulmonary embolism (PE) is a significant cause of morbidity and mortality.
- Early diagnosis and prompt treatment are essential for improving patient outcomes.
- Subtle presentations in pediatric patients can lead to delayed diagnosis.
Observation:
- This case highlights a pediatric patient with pulmonary embolism.
- The patient presented with dyspnea, chest pain, and hemoptysis.
- Subtle signs and symptoms in children necessitate a high index of suspicion.
Findings:
- Pulmonary embolism (PE) should be considered in pediatric patients with dyspnea and risk factors.
- A thorough hypercoagulable workup is recommended before starting anticoagulation.
- Delayed diagnosis of PE can occur if not actively considered.
Implications:
- Increased awareness of PE in pediatric populations is needed.
- Implementing standardized diagnostic protocols for suspected PE in children is crucial.
- Timely diagnosis and management of PE can significantly improve pediatric outcomes.
Abstract:
Correct and early diagnosis, along with appropriate therapy, should limit mortality. In the pediatric population, signs and symptoms may be subtle. PE should be on the differential diagnosis in patients that present with dyspnea in association with significant risk factors, chest pain, or hemoptysis. PE may be missed if a high index of suspicion is not maintained. In a patient with a PE, an appropriate hypercoagulable workup (Table 1) needs to be considered prior to initiation of anticoagulation therapy. This case highlights the need for further awareness.