Inferior Vena Cava Filter Strut Embolized Across the Interventricular Septum to the Left Ventricular Apex.

BACKGROUND

Inferior vena cava (IVC) filter fracture and embolization are rare but serious complications. Cardiac migration, particularly transseptal migration into the left ventricle, is exceptionally uncommon and can mimic inflammatory cardiomyopathies.

CASE SUMMARY: A 73-year-old woman with a remote IVC filter presented with pleuritic chest pain and elevated troponin, initially treated as myopericarditis. Cross-sectional imaging revealed a metallic foreign body traversing the interventricular septum into the left ventricular apex, consistent with a fractured IVC filter strut. Both surgical and percutaneous retrieval attempts failed because of dense myocardial embedding. She remained hemodynamically stable and was managed conservatively with anticoagulation, diuretics, and close follow-up with future removal of the IVC filter.

DISCUSSION: This case demonstrates an extraordinary migration pattern of an IVC filter strut, emphasizing the importance of multimodal imaging, multidisciplinary decision-making, and individualized management when standard retrieval strategies carry high risk.

TAKE-HOME MESSAGE: IVC filter strut embolization can mimic myocarditis; imaging and multidisciplinary evaluation guide safe management.