Paradoxical embolism across a patent foramen ovale (PFO) is a rare clinical entity and the thrombus is rarely caught passing through a PFO. A 65-year-old woman presented with dyspnea and pleuritic chest pain. Lower extremity venous Doppler ultrasound showed bilaterally extensive thrombosis at deep veins. Transthoracic echocardiographic examination showed two masses in both left and right atriums. In transesophageal echocardiography (TEE) interatrial septum was thin and aneurysmatic and a thrombus wedged through a patent foramen ovale and lodged in both atriums was demonstrated. We considered this mass as a thrombus crossing through a patent foramen ovale. He refused surgery and during anticoagulation therapy the patient had brachial artery embolism. Embolectomy material was reported as a thrombus. (C) 2007 Elsevier Ireland Ltd. All rights reserved.