Echocardiographic identification of right-sided cardiac intracavitary thromboembolus in massive pulmonary embolism.

In a patient with clinical features of massive pulmonary embolism, two-dimensional echocardiography demonstrated an echo-dense mass moving freely across the tricuspid valve between the right atrium and right ventricle. This mass was also visualized at angiography, which in addition confirmed extensive pulmonary embolism. At autopsy, the mass was found to be a coiled thrombus, one end of which had become wedged in a probe-patent foramen ovale. In another patient, bedside echocardiographic demonstration of thrombus in the right ventricular outflow tract was followed by immediate and successful embolectomy.