Figure 1 A: Transesophageal echocardiography showing a massive thrombus in transit in the right atrium crossing the PFO shown by the white arrow, into the left atrium. B: Pulmonary embolism in the right pulmonary artery. C and D: The vermiform thrombus seen in the four chamber view in both atria and the left ventricle. RA: right atrium. LA: left atrium. RV: right ventricle. LV: left ventricle. AV: Aortic valve. TP: truncus pulmonalis. RPA: right pulmonary artery. PAE: pulmonary artery embolism.