Pulmonary and paradoxical embolism in protein C and S deficient patient.

We document the case of a 67-year-old woman who presented with a history of right upper quadrant anopia, dyspnea, hypoxemia, and a systolic murmur. An intracardiac embolus wedged at a patent foramen ovale was successfully removed by resecting the atrial septum along with a pulmonary embolectomy on cardiopulmonary bypass. We review the literature with specific focus on the pathogenesis and acute treatment options of this life-threatening occurrence.