[Acute massive pulmonary embolism with thrombus entrapped in patent foramen ovale]

Thromboembolic disease is a potentially severe pathology, which can represent a life threat if it is not diagnosed early, especially when the cardiopulmonary backup is limited. When its clinical feature implies a massive occlusion of the arterial pulmonary tree and a cardiac failure is ensued, it can be seriously life threatening, even for young patients. Less frequent features as right or left atrium thrombosis could increase de morbidity and mortality of this disease. We present the case of a young woman with severe respiratory insufficiency. The CT pulmonary angiography revealed an acute massive pulmonary embolism, with a right atrium thrombus extending towards the left atrium, through a patent foramen ovale. We discuss the imaging characteristics and the importance of the precise information obtained with the CT pulmonary angiography, essential in the rapid establishment of a given treatment protocol and an outcome prognosis for the patient.