[Thrombus in all four heart chambers in a 67-year-old female patient with pulmonary artery embolism and open foramen ovale].

A 67-year-old woman presented to the emergency department due to acute dyspnea. Computed tomography of the chest showed a pronounced bilateral pulmonary artery embolism. Echocardiography demonstrated a large floating thrombus in the right atrium and right ventricle, which extended through a persistent foramen ovale via the left atrium into the left ventricle.