{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,3]],"date-time":"2026-05-03T00:48:34Z","timestamp":1777769314048,"version":"3.51.4"},"reference-count":12,"publisher":"BMJ","issue":"4","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2026,4,15]]},"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:p>Pregnancy in women with autosomal dominant polycystic kidney disease (ADPKD) complicated by significant cardiovascular disease is high risk. We report a multiparous woman in her late 30s with ADPKD, chronic hypertension and prior anterior wall myocardial infarction who was found to have a left ventricular mural thrombus at 12 weeks\u2019 gestation. She was managed with anticoagulation, pregnancy-adjusted antihypertensive therapy and multidisciplinary care. Fetal growth restriction developed at 32 weeks, and emergency caesarean delivery was performed at 35 weeks for absent end-diastolic flow in the umbilical artery. A live infant was delivered with good neonatal outcome. The mother had an uncomplicated postpartum recovery, and follow-up echocardiography showed partial thrombus resolution. This case highlights the complex interaction between ADPKD, cardiovascular disease and pregnancy and underscores the importance of individualised anticoagulation, strict blood pressure control and coordinated multidisciplinary management to optimise maternal and fetal outcomes.<\/jats:p>","DOI":"10.1136\/bcr-2026-273252","type":"journal-article","created":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T16:15:39Z","timestamp":1777479339000},"page":"e273252","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Pregnancy complicated by left ventricular mural thrombus in a hypertensive patient with autosomal dominant polycystic kidney disease and previous myocardial infarction"],"prefix":"10.1136","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5500-6109","authenticated-orcid":false,"given":"Sivaranjani","family":"P","sequence":"first","affiliation":[{"name":"Obstetrics and Gynaecology, Jawaharlal Institute of Postgraduate Medical Education, Puducherry, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bhabani","family":"Pegu","sequence":"additional","affiliation":[{"name":"Jawaharlal Institute of Postgraduate Medical Education, Puducherry, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Subbaiah","family":"Murali","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynaecology, Jawaharlal Institute of Postgraduate Medical Education, Puducherry, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A Shaheer","family":"Ahmed","sequence":"additional","affiliation":[{"name":"Cardiology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gowri","family":"Dorairajan","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynaecology, Jawaharlal Institute of Postgraduate Medical Education, Puducherry, India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2026,4,29]]},"reference":[{"key":"2026042909151977000_19.4.e273252.1","doi-asserted-by":"publisher","DOI":"10.1038\/ki.2009.128"},{"key":"2026042909151977000_19.4.e273252.2","doi-asserted-by":"publisher","DOI":"10.1159\/000343281"},{"key":"2026042909151977000_19.4.e273252.3","doi-asserted-by":"crossref","DOI":"10.1186\/s12882-019-1560-2","article-title":"Clinical practice guideline on pregnancy and renal disease","volume":"20","author":"Wiles","year":"2019","journal-title":"BMC Nephrol"},{"key":"2026042909151977000_19.4.e273252.4","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gft513"},{"key":"2026042909151977000_19.4.e273252.5","doi-asserted-by":"publisher","DOI":"10.18632\/oncotarget.14269"},{"key":"2026042909151977000_19.4.e273252.6","doi-asserted-by":"publisher","DOI":"10.1016\/0735-1097(89)90463-4"},{"key":"2026042909151977000_19.4.e273252.7","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcmg.2008.09.011"},{"key":"2026042909151977000_19.4.e273252.8","doi-asserted-by":"publisher","DOI":"10.1161\/STR.0000000000000024"},{"key":"2026042909151977000_19.4.e273252.9","doi-asserted-by":"crossref","first-page":"367","DOI":"10.1016\/j.amjcard.2019.05.009","article-title":"Efficacy of Direct Acting Oral Anticoagulants in Treatment of Left Ventricular Thrombus","volume":"124","author":"Fleddermann","year":"2019","journal-title":"Am J Cardiol"},{"key":"2026042909151977000_19.4.e273252.10","article-title":"The use of direct oral anticoagulants for left ventricular thrombus: a systematic review","volume":"18","author":"Jones","year":"2020","journal-title":"Thromb J"},{"key":"2026042909151977000_19.4.e273252.11","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.V551178"},{"key":"2026042909151977000_19.4.e273252.12","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2201295"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2026-273252","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T16:15:40Z","timestamp":1777479340000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2026-273252"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4]]},"references-count":12,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2026,4,29]]},"published-print":{"date-parts":[[2026,4]]}},"alternative-id":["10.1136\/bcr-2026-273252"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2026-273252","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4]]}}}