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A 35-year-old female patient presented with a 3-month history of progressive dyspnoea. The patient reported that since the onset of symptoms, she experienced tachycardia, cyanosis and presyncope after light exertion. At that time, the patient underwent a chest CT angiography, which was positive for pulmonary thromboembolism. Following this diagnosis, the patient started anticoagulation with rivaroxaban. However, after 2 months of anticoagulation, she reported no improvement and looked for a second opinion.