2013	Right lower limb swelling improved spontaneously.
	Left lower limb swelling diagnosed as DVT and was prescribed warfarin for 6 months.
2016	Developed hemoptysis and was diagnosed to be acute PE.
	Diagnosed as SLE with antiphospholipid syndrome.
	Received immunosuppressive and warfarin.
2018	Developed gradually progressive dyspnea occurring on minimal effort, palpitations, and bilateral lower limb edema.
1 month before admission	Developed severe decompensated heart failure and was admitted to Aswan Heart Center.
During hospital stay	Pulmonary endarterectomy and tricuspid valve repair was performed. The patient had smooth post-operative recovery and was discharged on medical therapy