High-risk pulmonary embolism in the first trimester of pregnancy: Successful thrombolysis with tenecteplase

Pulmonary embolism is a rare but potentially life-threatening complication during pregnancy, and its diagnosis remains challenging because of nonspecific clinical manifestations that may overlap with other pregnancy-related conditions. We report the case of a 38-year-old pregnant woman who presented with bilateral pulmonary embolism associated with hemodynamic and respiratory instability. Computed tomography pulmonary angiography was performed to confirm the diagnosis despite concerns regarding fetal radiation exposure, and the patient subsequently received thrombolytic therapy with a favorable short-term outcome. This case highlights the critical role of imaging in the diagnosis of high-risk pulmonary embolism during pregnancy and emphasizes the importance of timely multidisciplinary management. Early recognition and appropriate treatment are essential to improve maternal and fetal outcomes in this potentially fatal condition.