Impending paradoxical embolism from atrial thrombus: correct diagnosis by transesophageal echocardiography and prevention by surgery.

During recovery from a posterolateral myocardial infarction, a 56 year old patient developed signs of deep vein thrombophlebitis and subsequently of pulmonary embolism. After conventional echocardiography showed masses in both atria, transesophageal two-dimensional echocardiography clearly revealed an elongated mass overriding an atrial septal defect. Impending paradoxical embolism was confirmed at surgery.