Floating right heart thrombus and massive pulmonary embolism

Right heart thrombi are a severe form of venous thromboembolic disease and justify diagnosis and treatment in emergency. Free-floating right heart thrombi are a rare phenomenon, generally diagnosed when echocardiography is performed in patients with suspected or proven pulmonary embolism, and have a dismal prognosis if not diagnosed and treated in a timely manner. In our case which presented and treated in December 2010, thrombolytic therapy was the treatment of choice, although other treatment options are available, including anticoagulation and embolectomy.