Pulmonary Embolism and Thromboembolic Disease

Abstract Pulmonary thromboembolism (PTE) is an uncommon but potentially life-threatening condition in pediatrics. Most children with venous thromboembolism (VTE) and PTE share common risk factors that include vascular endothelial injury and thrombophilia. The source of vascular endothelial injury most frequently implicated is the use of a central venous line (CVL). The diagnosis of PTE may be difficult because hypoxemia and chest pain are nonspecific signs and symptoms and overlap with many other pulmonary conditions. While percutaneous pulmonary arteriography remains the gold standard for demonstrating PTE, multidetector computed tomography pulmonary angiography (CTPA) has become the diagnostic imaging modality of choice. Treatment decisions and anticoagulation choices depend on the clinical context and presentation. Invasive interventions such as embolectomy are reserved for patients made hemodynamically unstable by their PTE.