ArticleJACC. Case reports2026
Pulmonary Embolism, Silent Stroke, and an Occult Caval Thrombus: 1 Clot, 3 Territories.
Article in JACC. Case reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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4 authors.
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Abstract
backgroundClot in transit (CIT) through a patent foramen ovale (PFO) with concomitant pulmonary embolism is a rare condition that carries high mortality and lacks established management guidelines. CASE SUMMARY: A 67-year-old woman presented with 5 days of exertional dyspnea. Echocardiography showed a mobile thrombus traversing the atrial septum through a PFO with right ventricular dysfunction. Computed tomography pulmonary angiography demonstrated a saddle embolus, and brain imaging revealed a clinically silent paradoxical infarct. Compression ultrasonography showed no deep vein thrombosis. During emergency embolectomy with PFO closure, an unsuspected inferior vena cava thrombus was retrieved. DISCUSSION: CIT requires direct assessment of the pulmonary, systemic arterial, and venous axes before reperfusion is selected; computed tomography pulmonary angiography does not reliably assess the inferior vena cava. TAKE-HOME MESSAGE: When CIT is identified, interrogate the caval axis directly rather than inferring it from a negative pulmonary angiogram.
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