A Transesophageal Echocardiography (TEE) is essential in identifying thrombus in transient in patients with deep venous thrombosis (DVT) presenting with symptoms suggesting potential systemic emboli. We present a case of a 71-year-old gentleman with recent DVT who developed slurred speech and was assumed to have transient ischemia attack (TIA). TEE showed the presence of a large Thrombus in Transit (TIT) through a patent foramen ovale (PFO). Surgical intervention in low to intermediate risk is probably the best option associated with fewer complications of recurrent embolic events than both thrombolysis and anticoagulation.

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