May-Thurner Syndrome: Is It on Our Radar?

May-Thurner syndrome (MTS) is a vascular condition in which the right iliac artery compresses the left iliac vein against the lumbar spine. MTS can present as either acute or chronic deep vein thrombosis (DVT), which may lead to pulmonary embolism (PE). We present the case of a 61-year-old female with a medical history of unprovoked DVT on rivaroxaban, who presented with pain and swelling of the left lower limb, associated with shortness of breath for two weeks. Radiological investigations confirmed DVT with unilateral MTS involving the left common iliac vein. Therefore, MTS should be considered as a differential diagnosis in older women presenting with DVT and PE, particularly in cases of recurrence or other unprovoked thromboembolic events.