We present a case of a 41-year-old female with deep vein thrombosis after
abdominal surgery. The patient quickly developed severe pulmonary embolism and
stroke representative of paradoxical embolism. Echocardiography showed a
thrombus straddling a patent foramen ovale, which was confirmed
intraoperatively. An accurate diagnosis and rapid treatment decisions are
crucial for preventing patient deterioration in the form of new pulmonary
embolisms or stroke.