Trapped thrombus in patent foramen ovale with pulmonary embolism and homonymous paracentral scotoma

A 37-year-old female presented with persistent dyspnea and syncope. Computed-tomography scan detected saddle pulmonary embolism, and echocardiogram revealed extensive thrombus crossing the interatrial septum and prolapsing across the mitral valve into the left ventricle. Consequently, the patient was treated with surgical extraction of the thrombus and pulmonary embolectomy. She was discharged after un-eventful hospital stay save a dark grey spot in her central vision, which was diagnosed as homonymous paracentral scotoma caused by pre-operative cerebral infarction.