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February 26, 2026European Heart Journal - Case Reports0 citationsOpen Access

Snake in the Heart: A rare IVC to Pulmonary Artery Thrombus in Pregnancy.

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QYQayoom YousufARAaamir RashidSPSameer Purra

Key Result

Systemic thrombolysis markedly regressed a rare IVC to pulmonary artery thrombus in a 26-week pregnant woman with Protein C deficiency, enabling safe delivery.

Key Points

  • This case report highlights the identification and management of a rare thrombus in a pregnant patient.
  • Case report of a 26-week pregnant woman with a thrombus extending from the iliac veins to the pulmonary artery.
  • Utilization of echocardiography and cardiac MRI to visualize thrombus morphology.
  • Implementation of systemic thrombolysis to manage the thrombus.
  • The continuous thrombus was successfully identified and treated using multimodal imaging.
  • Marked regression of the thrombus occurred after thrombolysis treatment.
  • The patient remained stable throughout the process and delivered safely.

Structured PICO

P
Population
1 pregnant woman at 26 weeks gestation with a continuous thrombus from the iliac veins through the IVC into the right heart and pulmonary artery, and underlying Protein C deficiency.
I
Intervention
Systemic thrombolysis and multimodality imaging (Echocardiography and CMR)
O
Outcome
Thrombus regression and maternal/fetal clinical stability (safe delivery)

Systemic thrombolysis guided by multimodality imaging can be successfully utilized for massive, continuous IVC-to-pulmonary artery thrombosis during high-risk pregnancy.

Abstract

A 26-week pregnant woman was found to have a rare continuous thrombus from the iliac veins through the IVC into the right heart and pulmonary artery. Echocardiography and CMR clearly defined the entire “snake-like” thrombus. Systemic thrombolysis led to marked regression, and evaluation revealed Protein C deficiency. The patient remained stable and delivered safely, highlighting the value of multimodality imaging and the role of individualized thrombolysis in high-risk pregnancy-associated thrombosis.

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Cite This Study

Yousuf et al. (2026) studied this question. Systemic thrombolysis markedly regressed a rare IVC to pulmonary artery thrombus in a 26-week pregnant woman with Protein C deficiency, enabling safe delivery.

synapsesocial.com/papers/699fe35995ddcd3a253e714chttps://doi.org/10.1093/ehjcr/ytag119
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