Abstract Pulmonary embolism (PE) is a relatively common cardiovascular disorder with high early mortality rates, despite advances in diagnosis and treatment. The risk of mortality is quite high in case the diagnosis is missed. High clinical suspicion is crucial in the diagnosis, more so in the young. Rarely, systemic embolism can occur in a patient with PE through a preexisting patent foramen ovale (PFO) (paradoxical embolism). Paradoxical embolism is associated with very high mortality rates. We report the case of a 31-year-old male, who was diagnosed with massive PE by echocardiography along with a thrombus-in-transit, trapped in a PFO, but without systemic embolization.

Almost a Double Whammy! Acute Pulmonary Embolism and an Impending Paradoxical Embolism

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