A thrombus in transit through a patent foramen ovaleIbebuogu, Uzoma N. MD, FACC; Khouzam, Rami N. MD, FACC, FACP, FASNC, FASE, FSCAI; Sharma, Gyanendra MD, FACC; Thornton, John W. FACC; Robati, Roshanak MS; Silverman, David MDJournal of the American Academy of PAs: October 2014 - Volume 27 - Issue 10 - p 32–35 doi: 10.1097/01.JAA.0000446233.16049.01 Case Report Buy Abstract Author InformationAuthors Article MetricsMetrics ABSTRACT Patent foramen ovale (PFO) is a congenital heart defect that may first be diagnosed in adulthood and has a prevalence of 25% to 30%. Although many patients with PFO are asymptomatic and do not require treatment, paradoxical embolism can cause stroke or myocardial infarction. The authors report an unusual case of PFO with a transversing thrombus in an 80-year-old man. The patient's initial presentation appeared clinically as acute coronary syndrome, but he was subsequently diagnosed with a massive thrombus in transit via a PFO and pulmonary embolus leading to right-sided heart failure. At the University of Tennessee Health Science Center in Memphis, Uzoma N. Ibebuogu is an assistant professor and Rami N. Khouzam is an associate professor. At Georgia Regents University in Augusta, Gyanendra Sharma and John W. Thornton practice in the Division of Cardiology, Roshanak Robati practices in the School of Medicine, and David Silverman practices in the Department of Medicine. The authors have disclosed no potential conflicts of interest, financial or otherwise. © 2014 American Academy of Physician Assistants.