47 year old male with no significant PMHx who presented to ED c/o chest pain and sob x 12h
As a part of ED work up they ordered stat TTE I did his echo and as everyone can see a large mobile echogenic mass (measuring ~ 5-6 x 2 cm) moving in-and-out of the tricuspid annulus, most likely representing thrombus/emboli in transit.
Final diagnosis was
PE in patient with RCC
occur due to tumors emboli from the involvement of the IVC with local tumor extension
Great case, thank you Nader.