High-Risk Pulmonary Embolism During Labor JACC Patient Care Pathways

While in labor, a 37-year-old woman developed acute dyspnea, hypoxemia, and tachycardia. Transthoracic echocardiography demonstrated severe right ventricular dilation and dysfunction, raising the suspicion of acute pulmonary embolism. The patient indeed had bilateral pulmonary embolism, necessitating percutaneous thrombectomy. Her course was complicated by another saddle pulmonary embolus, heparin-induced thrombocytopenia, and COVID-19 infection. This clinical case illustrates the importance of prompt diagnosis of acute pulmonary embolism in a peripartum female patient, the multidisciplinary approach of management, and how to approach clinical complications such as heparininduced thrombocytopenia. Furthermore, long-term management in acute pulmonary embolism is presented. (J Am Coll Cardiol 2023;81:283-291) (c) 2023 by the American College of Cardiology Foundation.