A 25-year-old @entity1 presented with complaints of @entity662 , @entity1353 , and decreasing exercise tolerance. His vital signs were normal, with the exception of an @entity26 saturation level of 93% while breathing room air. During his assessment, he developed @entity1002 , left arm and @entity425 , and an @entity2055 , which lasted 15 min then resolved spontaneously. Cardiac enzyme levels were elevated, and an ECG revealed T-wave inversion in leads III, aVF, V1, and V2 with evolving ST-segment elevation in leads V3 through V5. The findings of a CT scan and MRI of the head were negative; a Doppler ultrasound of the right lower extremity revealed a @entity715 extending from the common femoral vein to the popliteal vein. Cardiac catheterization revealed no evidence of @entity453 . CT pulmonary angiography revealed @entity1151 . Transesophageal echocardiography (TEE) showed a 4-cm, dumbbell-shaped mass lodged in a @entity4616 , confirming the diagnosis of an impending @entity2121 . The @entity1 was started on therapy with unfractionated heparin, and his @entity715 resolved spontaneously by hospital day 5. An impending @entity2121 is rare but should be suspected in anyone presenting with evidence of both @entity455 . The therapeutic options include anticoagulation, thrombolysis, and surgical embolectomy. We would propose that initial treatment with anticoagulation therapy and following with serial TEEs may be appropriate therapy in an otherwise stable @entity1 , with surgical embolectomy or thrombolysis reserved for the treatment of thrombi that do not resolve with anticoagulation therapy or for @entity1 with clinical deterioration.

Impending @entity2121 presenting as a XXXX , transient ischemic attack, and myocardial infarction.

@entity1 :: ('9606', 'Species') :: ['patients', 'patient', 'man'] @entity662 :: ('MESH:D002637', 'Disease') :: ['nonpleuritic, substernal chest pain'] @entity455 :: ('MESH:D014652', 'Disease') :: ['venous and arterial emboli'] @entity1353 :: ('MESH:D004417', 'Disease') :: ['dyspnea'] @entity26 :: ('MESH:D010100', 'Chemical') :: ['oxygen'] @entity2055 :: ('MESH:D001259', 'Disease') :: ['ataxic gait'] @entity425 :: ('MESH:D018908', 'Disease') :: ['leg weakness'] @entity1151 :: ('MESH:D011655', 'Disease') :: ['bilateral pulmonary emboli'] @entity2121 :: ('MESH:D019320', 'Disease') :: ['paradoxical embolism'] @entity453 :: ('MESH:D003324', 'Disease') :: ['epicardial coronary artery disease'] @entity715 :: ('MESH:D013927', 'Disease') :: ['thrombus'] @entity4616 :: ('MESH:D054092', 'Disease') :: ['patent foramen ovale'] @entity1002 :: ('MESH:D018487', 'Disease') :: ['transient left facial droop']
@entity1151 :: (MESH:D011655,Disease) :: ['pulmonary embolism']
