Large embolic clot in transit straddling across patent foramen ovale-
Thrombotic railroading from LV outflow to right ventricle
Abstract
Clot in transit represent the embolized fragment of deep vein thrombosis
seen in cardiac chamber during its transit. Impending paradoxical emboli
is seen in situation with high right atrial pressure than left atrium
where clot gets caught in the patent foramen ovale or rarely atrial
septal defect. High mortality of upto 18% has been seen in patients
with paradoxical embolus in transit. Current case demonstrates patient
with acute massive pulmonary embolism with large clot in transit seen in
right side of heart extending across atrial septum to the left side of
heart, extending across the aorta valve.