A free-floating thrombus in the right heart associated with pulmonary embolism: the role of echocardiography.

Free-floating right heart thrombi are rare and usually represent travelling clots from venous system to the lung. Almost exclusively, they are associated with pulmonary embolism. Despite associated high mortality, they are frequently under-diagnosed. We report a case of bilateral pulmonary embolism which was found to have a free-floating right atrial thrombus on echocardiography. The case, therefore, highlights the importance of echocardiography as a key examination in this setting. It can be performed at bedside to directly visualize the thrombi, assess and monitor right ventricular (RV) function, and help in making treatment decisions.