Figure 3: (a) Transthoracic echocardiography showed a mobile mass filling the half of the right atrium (  cm in size) (arrow) extending the right ventricule (  cm in size) and into the vena cava. (b) Contrast-enhanced CT angiographic image shows a large filling defect in the right atrium extending into the right ventricle (asterisks). Segmental arteries in both lower lobes are of small calibre due to chronic thromboembolism (arrows). Pulmonary hypertension resulted in straightening of the interventricular septum. (c) Both lower lobe arteries contain central filling defects (arrows) representing superimposed acute pulmonary embolism.