Behçet's Disease Presenting With Large Intracavitary Thrombi and Pulmonary Embolism

Behçet's disease (BD) is a rare chronic multisystem inflammatory disorder characterized by recurrent mucocutaneous, ocular, musculoskeletal, and vascular manifestations. Although vascular involvement is common, cardiac manifestations are exceptionally rare and can be life-threatening. We report a unique case of a 24-year-old male who presented with haemoptysis and right-sided chest discomfort. Echocardiography demonstrated multiple right ventricular thrombi, and a CT pulmonary angiogram confirmed extensive thrombi with near-total occlusion of the left pulmonary artery. Despite hemodynamic stability, the significant thrombus burden and presence of right ventricular thrombus prompted thrombolysis with intravenous Alteplase, resulting in clinical improvement, followed by anticoagulation therapy. Further workup, including HLA-B51 testing and the presence of recurrent folliculitis, supported a diagnosis of Behcet's disease. This report emphasizes the importance of early recognition and combined immunosuppressive and anticoagulant therapy to manage this rare but fatal presentation.