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Cardiotoxicity after anthracycline use predictably occurs within the first year of therapy and is dose-related, with variable degrees of recovery. While the need for hospitalisation for heart failure was uncommon, medical therapy appears underutilised, suggesting there may be a role for improved surveillance and early initiation of treatment.

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Background Inferior vena cava (IVC) filters are used to prevent pulmonary embolism in patients at high risk of venous thromboembolism with a contraindication to anticoagulation. IVC filters are associated with rare but significant long term complications such as filter fracture and embolisation. Case summary We report the case of a 53-year-old female with an IVC filter inserted eight years prior for the management of recurrent bilateral pulmonary embolism resistant to anticoagulation. Imaging revealed an incidental finding of IVC filter limb fracture and migration to the right heart, and the hepatic and renal vein. The patient remained asymptomatic with no impairment in cardiac, liver or renal function. Due to high operative risk, the broken IVC filter and embolised filter limbs were not retrieved. Discussion There is no consensus on management for intracardiac embolisation of IVC filters. Intravascular fragments may be removed by endovascular or surgical approaches, depending on anatomical location. Following IVC filter insertion, the appropriate follow up must be in place to ensure removal and limit clinical sequalae that is otherwise avoidable. A multidisciplinary approach to the management of IVC filter fracture and embolisation is recommended.

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