Table of Contents

ABSTRACT

Pulmonary embolism occurs when a thrombus forms in the venous vasculature and propagates to the pulmonary vasculature. These clots, often asymptomatic prior to potentially fatal migration, are an increasing problem in both the pediatric and adult population. Mortality and morbidity from acute pulmonary embolism remain high. After a review of the historical context of venous thrombo-embolism (VTE), this discussion details the recent increase in and risk factors for VTE in children. Presenting symptoms and pathophysiology are reviewed followed by a discussion of diagnostic modalities and strategies. A brief review of standard therapeutic options is provided that includes unfractionated heparin (UFH), low molecular weight heparin (LMWH), warfarin (coumadin) and synthetic heparin. This is followed by a look at the novel oral anticoagulation agents (NOACs). Interventional management strategies for pulmonary embolism are reviewed in a subsequent treatise in this volume. Finally, there are comments on the impact of Covid-19 infection on thrombo-embolic disease.

Keywords: Pediatrics, pulmonary disease, pulmonary embolism, United States