PULMONARY THROMBOEMBOLISM IN ADOLESCENTS CASE REPORT
Abstract:
This paper presents the case of a patient aged 17 years who had a syncope after physical
exertion. Paraclinical assessment aimed to detect the main causes of the syncope, exogenous causes as
well as endogenous neurological, vascular, and metabolic disorders being excluded. Transthoracic
echocardiography showed slight pulmonary hypertension, and transesophageal echocardiography
raised the suspicion of a right atrial formation (not confirmed by cardiac MRI). Pulmonary perfusion
scintigraphy revealed the suppression of perfusion in the first apical segment of the left upper lobe of the
lung, allowing to establish the diagnosis of pulmonary thromboembolism. The determination of the
parameters involved in the etiology of thrombophilia allowed to exclude the Leiden mutation and
antithrombin III, S and C protein deficiency. Emergency treatment was initiated with iv heparin,
followed by oral anticoagulants, with strict INR monitoring. The observation presented draws attention
to the need for a complete evaluation of patients with syncope, considering the possibility of pulmonary
thromboembolism
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