Pulmonary embolism secondary to uterine fibroid: A case report of a rare presentation

Large Pulmonary Embolism with right heart strain in the presence of massive vaginal bleed is an uncommon presentation in middle aged women. Pulmonary embolism and Deep Vein Thrombosis are both rare and life-threatening conditions for women with uterine fibroids. We report a case of a 41-year-old Indian American woman with a history of uterine leiomyoma and menorrhagia, who presented to the emergency department with shortness of breath and 6 out of 10 retrosternal chest pain. CT angiography showed massive bilateral pulmonary embolism with 5 cm benign right ovarian tumor and venous Doppler showed left deep vein thrombosis at femoral level. We successfully treated the patient with rapid intervention through thrombolysis followed by anticoagulation after initial stoppage of the bleeder points by targeted uterine artery embolization. Further studies can aim at early detection to minimize morbidity and mortality in females with uterine fibroids presenting with thromboembolic phenomenon.