This 24M presented with acute onset CP/SOB, hypoxia, HR 150s. What's the diagnosis? Treatment options? Hint: this is a rare echo finding! ... Thrombus in transit seen in RA. dilated RV with McConnell's sign. Pt had extensive bilateral PTE. Started on heparin then taken for EKOS catheter-directed thrombolysis, aspiration thrombectomy. Discharged 3 d later with normal LV and RV function. #Clinical #POCUS #Echocardiogram #A4C #McConnells #Sign #PulmonaryEmbolism #Thrombus #Clots #InTransit