A pulmonary embolism (PE) is a medical emergency. One of the arteries (large blood vessels) in the lungs becomes blocked by a blood clot that travels from the leg or another part of the body.

While this condition is most common among adults ages 40 and above, it can also occur in babies, children, and teens.

Here’s how to spot the symptoms of pulmonary embolism in kids, how doctors diagnose this condition, and what the outcome may be after treatment.

Any situation that allows a blood clot to form in the body may lead to pulmonary embolism. Clots most commonly form in the legs, which is called deep vein thrombosis (DVT).

They can also form elsewhere, including the veins in the abdomen, arms, pelvis, or even in the brain. With time, the clot may travel to the lungs, fully or partially blocking off the blood supply.

While uncommon in kids, there are some situations where a child may develop a pulmonary embolism. For example, children with congenital heart disease, infection, or a central venous line (CVL) for cancer treatment may be at particularly high risk.

Other conditions that put kids at risk include:

Age and race may play a role as well. A 2017 review suggests infants, toddlers, and adolescents are more likely to develop PE than kids of other ages. The study also suggests that Black children are more likely to develop PE than white children.

A 2021 study notes that disparities in healthcare access and quality can influence PE severity and mortality in Black populations.

If your child has risk factors and is also having issues with breathing or complaining of chest pain, be sure to pay close attention.

Symptoms of PE may include:

That said, experts share that children may not always show these classic signs. Instead, they may be asymptomatic, or their symptoms may be nonspecific.

As a result, doctors may not always come to a diagnosis quickly. They may misdiagnose it as pneumonia or heart failure.

Seek emergency care

A pulmonary embolism is a medical emergency. Call emergency services or seek immediate medical attention if your child develops any symptoms associated with PE.

Diagnosing PE in children involves first discussing your child’s medical history and risk factors.

A physical exam may help assess issues with breathing, pain, or related symptoms. But signs of PE can mimic other illnesses, so some tests can aid your doctor with making a specific diagnosis.

Imaging via CT scans or MRI scans is considered to be the most useful diagnostic tool available today. These scans are also noninvasive and relatively safe. MRIs are especially safe as they do not expose children to high doses of radiation.

A ventilation/perfusion (VQ) scan is another option your doctor may suggest. This diagnostic tool can measure:

  • how air is flowing through the lungs
  • how and where blood is flowing
  • where blood flow is blocked

The problem with diagnosis is that many kids have few to no symptoms. As a result, some studies have shown that a diagnosis of PE in children may take as long as 7 days.

Treatment for PE generally involves medications to thin the blood, like:

Also known as anticoagulation therapy, blood-thinning medications help prevent clots from growing and slow new clots from forming.

Other treatment options include:

  • Thrombolysis. Also called fibrinolytic therapy, this method involves using medication to break up existing blood clots.
  • Thrombectomy. This minimally invasive surgical procedure physically removes clots from the arteries or veins.
  • Inferior vena cava (IVC) filter. This device can keep clots from reaching the lungs. It’s generally only used with children who weigh more than 22 pounds.

Pediatric patients receive treatment similar to adults with PE. Still, your individual child’s treatment will vary depending on factors, including age, health history, hospital practices, and how he or she responds to each treatment.

Again, since PE is less common in kids and may not produce notable symptoms, some doctors may overlook it as a diagnosis.

In a 2020 case study, 50 percent of children who experienced a PE had signs of the condition, but only a third received a correct initial diagnosis.

With the delay in diagnosis, the mortality rate of pulmonary embolism is somewhere around 10 percent in children. When kids get prompt diagnosis and medical care, on the other hand, their outlook is good.

Follow-up is critically important after treatment. Experts share that tracking the resolution, progression, or chance of recurrence is key. At least one study shows that Black and Hispanic children may be at the highest risk of recurrence.

Your child’s pediatrician will also use follow-up appointments to monitor for any long-term issues that may arise, like pulmonary hypertension or chronic PE.

While PE is rare in children, some kids may be at higher risk, either due to existing health conditions, age, or race.

Classic symptoms may include trouble breathing or chest pain. But many kids show no symptoms or nonspecific symptoms, making diagnosis difficult.

Fortunately, doctors are becoming more aware of the risks for PE in children so that diagnosis can be quicker and treatment can start sooner, leading to better outcomes.

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