RT Journal Article SR Electronic T1 The dilemma in the management of haemodynamically stable pulmonary embolism with right heart thrombus JF BMJ Case Reports JO BMJ Case Reports FD BMJ Publishing Group Ltd SP e229162 DO 10.1136/bcr-2018-229162 VO 12 IS 7 A1 Manoj P Rai A1 Khadar Herzallah A1 Ahmad Alratroot A1 Heather Laird-Fick YR 2019 UL http://casereports.bmj.com/content/12/7/e229162.abstract AB Right ventricular thrombus (RVT) can be life-threatening, since it has the potential to embolise and cause saddle pulmonary embolism (PE). We present a patient who initially presented with haemodynamically stable PE with evidence of RVT on echocardiogram. She was placed on heparin drip; however, she later developed cardiac arrest and died due to embolisation of RVT to the pulmonary vasculature. Although management of haemodynamically stable PE in patients with RVT is still a matter of debate,1 given the outcome we suggest that thrombolysis or emergent embolectomy at the presentation, in this case, may have had a favourable outcome.