Echocardiography may be used in patients presenting with pulmonary embolism to visualise the right heart. The authors report the case of a patient who had recurrent pulmonary embolism. Echocardiography demonstrated a large, mobile thrombus moving freely through the tricuspid valve. There were many cardiac and general contraindications to surgery and fibrinolytic therapy in this particular case. Nevertheless, the mass had totally disappeared on control echocardiography after anticoagulant therapy with heparin. There were no further embolic symptoms. The only change was observed on pulmonary scintigraphy. The patient was discharged a few weeks later on oral anticoagulant therapy. In comparison with previously published results, the outcome of this case was surprisingly good; surgery, which was impossible in our case, would seem to be the treatment of choice.
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