title: Thromboembolism-in-Transit and Patent Foramen Ovale: Should Screening Echocardiogram Be Routine for Thromboembolic Disease?
abstract: BACKGROUND
  Thromboembolism-in-transit straddling a patent foramen ovale (PFO) is a rare condition that requires urgent surgical intervention to prevent arterial emboli.
  
  
  METHODS
  We present the case of a 42-year-old female who presented with a symptomatic pulmonary embolism. Echocardiography identified a PFO, with a bridging thrombus-in-transit and evidence of right ventricular strain. Urgent surgery was performed because of the risk of systemic embolism. A large thrombus was identified during biatrial exploration. Pulmonary embolectomy and primary PFO closure were performed.
  
  
  CONCLUSIONS
  Because of the 20%-30% incidence of PFOs in the general population, we suggest that echocardiography should be considered for routine surveillance in thromboembolism because of the risk of systemic sequelae.
authors.affiliation: Center for Comprehensive Cardiovascular Care, Saint Louis University, St. Louis, MO.
authors.forename: Dawn S
authors.initials: DS
authors.lastname: Hui
authors.affiliation: Department of Cardiothoracic Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA.
authors.forename: Fernando
authors.initials: F
authors.lastname: Fleischman
authors.affiliation: Department of Cardiothoracic Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA.
authors.forename: P Michael
authors.initials: PM
authors.lastname: McFadden
keywords: Echocardiography; foramen ovale–patent; thromboembolism