Pulmonary embolism in children

Most of the pediatric pulmonary embolism (PE) cases are diagnosed in the autopsy studies because of not to be considered. We present six PE episodes in five children. Common symptoms and physical findings in our patients were chest pain, dyspnea, tacyhpnea, tachycardia and crackles in the lung. All cases were diagnosed as pneumonia before the diagnosis of PE. Five cases were treated with low molecular weight heparin and at the 3rd day coumadin was added to therapy and lasted for 3-12 months. Three of patients had to receive different thrombolytic therapies (streptokinase, urokinase and tissue plasminogen activator). During thrombolytic treatment one patient had a major nonfatal bleeding. Deep venous thrombosis was detected in four of the five patients and only two patients had congenital risk factors. The well known acquired risk factor for PE, central venous catheter, was present in three children. PE must take a place in the differantial diagnosis of acute chest pain, dyspnea, tachypnea especially in the children with risk factors for PE.