An Unusual Initial Manifestation of Pulmonary Embolism: Aseptic Cavitary Infarction With Pulmonary Hypertension—Case Report and Literature Review

Chronic thromboembolic pulmonary hypertension (CTEPH) is a rare but serious consequence of acute pulmonary embolism occurring in about 0.4%–6.2% of cases. Pulmonary infarction is an infrequent complication due to the lung's dual blood supply. Cavitary pulmonary infarction without infection is an exceedingly rare manifestation in CTEPH. We are reporting a 44‐year‐old woman who presented with lower limb swelling, cough, haemoptysis, and dyspnoea. Evaluation confirmed CTEPH with an aseptic cavitary infarct in the context of a heterozygous Factor V Leiden (1691G > A) mutation. She responded well to anticoagulation and riociguat, showing marked clinical improvement and complete resolution of the cavity on follow‐up imaging. Family screening showed that both children carried the same mutation, highlighting the value of genetic testing in patients with unexplained CTEPH.