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Persistent tachypnea in children: keep pulmonary embolism in mind
C H van Ommen1, H Heyboer, J W Groothoff
1Department of Pediatric Hematology, Emma Children's Hospital, Amsterdam, The Netherlands.
Insights
Pediatric tachypnea can indicate serious conditions like pulmonary embolism. Early diagnosis and anticoagulant treatment are crucial for favorable outcomes in children with venous thromboembolism risk factors.
Area of Science:
- Pediatric Pulmonology
- Cardiovascular Medicine
- Medical Diagnostics
Background:
- Tachypnea in children commonly stems from respiratory or non-respiratory issues like fever or cardiac disease.
- Pulmonary embolism (PE) is infrequently recognized by pediatricians as a cause of tachypnea.
Observation:
- Three pediatric cases with persistent tachypnea are presented: post-orthopedic surgery, nephrotic syndrome, and Hirschsprung disease.
- Diagnosis of pulmonary embolism was delayed in these cases, with other causes of tachypnea addressed first.
Findings:
- Ventilation-perfusion (V/Q) scanning indicated a high probability of pulmonary embolism in these patients.
- Initiation of anticoagulant therapy was commenced following diagnosis.
Implications:
- Pulmonary embolism should be considered in pediatric tachypnea, particularly with co-existing venous thromboembolism risk factors.
- Timely diagnosis and treatment of PE in children can prevent fatal outcomes and improve prognosis.
Purpose:
Tachypnea in children is associated with respiratory disorders and nonrespiratory disorders such as cardiac disease, metabolic acidosis, fever, pain, and anxiety. Pulmonary embolism is seldom considered by pediatricians as a cause of tachypnea.
Patients And Methods:
Three children of various ages with persistent tachypnea are described: a girl after orthopedic surgery for kyphoscoliosis, a boy with nephrotic syndrome, and a neonate with Hirschsprung disease. Other causes of tachypnea were diagnosed and treated before pulmonary embolism was considered.
Results:
Ventilation-perfusion scanning appeared to be highly probable for pulmonary embolism in these patients. Anticoagulant therapy was started.
Conclusion:
Pulmonary embolism should be kept in mind in children with tachypnea, especially when other risk factors for venous thromboembolism are present, to avoid delay in anticoagulant treatment and a fatal outcome.