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A 74-year old woman was admitted to the orthopaedic word due to femoral bone fracture. Six days later she was admitted to the intensive care unit because of the clinical signs of circulatory and respiratory failure. Because acute pulmonary embolism was suspected, transthoracic echocardiography was performed and showed typical signs of acute massive pulmonary embolism as well as a highly mobile, longitudinal, additional echo in the right atrium attached to the interatrial septum in the place of foramen ovale, prolapsing in the diastole into the right ventricle. The patient was immediately and successfully treated with thrombolysis. Treatment options in patients with acute pulmonary embolism and right atrial mobile thrombus are discussed.

The levels of serum fatty acids in the serum and in the serum fractions of cholesterol esters (ECH) and triglycerides (TG) and the levels of these acids in these fractions of platelets were compared in healthy controls and in patients with clinically manifested coronary arterial disease. Decreased level of linoleic acid was found in the serum and in the ECH fraction of the serum in the patients, with a rise in the level of palmitic acid in the ECH fraction of the serum of these patients. The level of linoleic acid in the ECH and TG platelet fractions in these patients was not different from that in the healthy controls, while in the platelet TG fraction of the patients the level of palmitoleic acid was raised, and the level of oleic acid was increased in the platelet ECH fraction.