title: Acute pulmonary embolism caused by enlarged uterine leiomyoma: a rare presentation.
abstract: METHODS
  Female, 42.
  
  
  METHODS
  Acute pulmonary embolism.
  
  
  METHODS
  Chest pain • dyspnea.
  
  
  METHODS
  Streptokinase • Warfarin.
  
  
  METHODS
  .-
  
  
  METHODS
  Cardiology and Neoplasm.
  
  
  OBJECTIVE
  Management of emergency care.
  
  
  BACKGROUND
  Deep venous thrombosis (DVT) and subsequent pulmonary embolism (PE) caused by pelvic vein compression are rare and life-threatening complications of leiomyoma of the uterus.
  
  
  METHODS
  We report a 42-year-old virgin woman with a history of leiomyoma who presented to the emergency department with complaints of dyspnea and pleuritic chest pain with transient spotting. On physical examination, she had a non-tender abdomen with a 20-week size uterus. Imaging investigations revealed an acute DVT in her left leg and a huge uterine-derived mass compressing the common iliac veins. Transesophageal echocardiography (TEE) demonstrated an echogenic mass in her right pulmonary artery consistent with thrombosis. The patient was completely cured using thrombolytic therapy and myomectomy, and was well at 1 year after thrombolysis.
  
  
  CONCLUSIONS
  PE caused by pelvic vein compression is a rare complication of leiomyoma, which should be considered. Thrombolytic therapy associated with myomectomy can be implemented for treating such cases, and TEE can be used for diagnosing suspected high-risk PE.
authors: Department of Cardiology, Seyyed-al-Shohada Heart Center, Urmia University of Medical Sciences, Urmia, Iran.
authors: Kamal
authors: K
authors: Khademvatani
authors: Seyyed-al-Shohada Heart Center, Urmia University of Medical Sciences, Urmia, Iran.
authors: Yousef
authors: Y
authors: Rezaei
authors: Department of Cardiology, Seyyed-al-Shohada Heart Center, Urmia University of Medical Sciences, Urmia, Iran.
authors: Abdollah
authors: A
authors: Kerachian
authors: Department of Cardiology, Seyyed-al-Shohada Heart Center, Urmia University of Medical Sciences, Urmia, Iran.
authors: Mir Hossein
authors: MH
authors: Seyyed-Mohammadzad
authors: Department of Cardiology, Firoozgar Hospital, Iran University of Medial Sciences, Tehran, Iran.
authors: Ramin
authors: R
authors: Eskandari
authors: Department of Cardiology, Seyyed-al-Shohada Heart Center, Urmia University of Medical Sciences, Urmia, Iran.
authors: Alireza
authors: A
authors: Rostamzadeh
mesh_terms: D000208:Acute Disease; D000328:Adult; D003937:Diagnosis, Differential; D017548:Echocardiography, Transesophageal; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007889:Leiomyoma; D008279:Magnetic Resonance Imaging; D009367:Neoplasm Staging; D011655:Pulmonary Embolism / Q000175:diagnosis / Q000209:etiology*; D014594:Uterine Neoplasms / Q000150:complications* / Q000175:diagnosis
keywords: Echocardiography; Leiomyoma; Pulmonary Embolism; Thrombolytic Therapy