Tehran University of Medical Sciences The Research in Heart Yield and Translational Medicine (RHYTHM) 3115-7270 21 2 2026 04 26 174 179 Kellyn Zenjaya Hang Tuah University Lindawati Wijoyo Faculty of Medicine, Hang Tuah University, Surabaya, Indonesia Santika Danubrata Faculty of Medicine, Hang Tuah University, Surabaya, Indonesia Hendrata Andisari Department of Internal Medicine, Dr. Ramelan Naval Centre Hospital, Surabaya, Indonesia Febryanti Hartono Department of Cardiology and Vascular Medicine, Dr. Ramelan Naval Centre Hospital, Surabaya, Indonesia 2025 12 16 2026 02 01 Bilateral deep vein thrombosis (DVT) is a rare condition among adolescents and represents an uncommon pattern of venous thromboembolism. We report a case of bilateral DVT occurring in the setting of severe pulmonary hypertension and right-sided heart failure secondary to congenital heart disease associated with congenital rubella syndrome (CRS). A 19-year-old female patient, with a history of CRS characterized by the classical triad of unilateral cataract, sensorineural deafness, and congenital heart disease, was admitted to our hospital with shortness of breath, swelling in both legs, and abdominal discomfort. Doppler ultrasonography demonstrated partial thrombotic obstruction of the femoral, popliteal, and posterior tibial veins in both lower extremities. A diagnosis of DVT was established on the fourth day of hospitalization. This case highlights the importance of considering bilateral DVT in patients with CRS who present with lower extremity edema, particularly in the presence of cardiovascular complications. https://jthc.tums.ac.ir/index.php/jthc/article/view/2409 https://jthc.tums.ac.ir/index.php/jthc/article/download/2409/1268