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Large embolic clot in transit straddling across patent foramen ovale- Thrombotic railroading from LV outflow to right ventricle
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  • Ankur Agarwal,
  • Ajitkumar Valaparambil,
  • Krishna Kumar Mohanan Nair,
  • Harikrishnan Sivadasanpillai,
  • Deepanjan Bhattacharya
Ankur Agarwal
Sree Chitra Tirunal Institute for Medical Sciences and Technology
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Ajitkumar Valaparambil
Sree Chitra Tirunal Institute for Medical Sciences and Technology
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Krishna Kumar Mohanan Nair
Sree Chitra Tirunal Institute for Medical Sciences and Technology
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Harikrishnan Sivadasanpillai
Sree Chitra Tirunal Institute for Medical Sciences and Technology
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Deepanjan Bhattacharya
Sree Chitra Tirunal Institute for Medical Sciences and Technology
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Abstract

Clot in transit represent the embolized fragment of deep vein thrombosis seen in cardiac chamber during its transit. Impending paradoxical emboli is seen in situation with high right atrial pressure than left atrium where clot gets caught in the patent foramen ovale or rarely atrial septal defect. High mortality of upto 18% has been seen in patients with paradoxical embolus in transit. Current case demonstrates patient with acute massive pulmonary embolism with large clot in transit seen in right side of heart extending across atrial septum to the left side of heart, extending across the aorta valve.