Abstract
Submassive pulmonary embolism (PE) with right heart strain and right ventricle thrombus is a complex and potentially life-threatening condition. Prompt recognition and management are crucial to optimizing patient outcomes. We present the case of a 59-year-old male with a history of obstructive sleep apnea (OSA) and non-compliance with continuous positive airway pressure (CPAP) therapy who presented with progressively worsening shortness of breath (SOB). Imaging studies revealed bilateral submassive PE with right heart strain and a thrombus in the right ventricle. Treatment included anticoagulation therapy and mechanical thrombectomy using the INARI FlowTriever device. This case highlights the importance of early recognition and risk factor assessment, such as using testosterone boosters, considering right ventricle thrombus as a complication of PE, and the role of mechanical thrombectomy in selected cases.