Right heart emboli-in-transit have been echocardiographically documented in up to 4 to 23% of patient with acute pulmonary embolism. The most appropriate therapeutic approach still remains an unresolved problem because there are no prospective and randomized trials to definitively answer this question. Thrombolysis seems to be the more attractive alternative. We report a case of 44 years old man presented with a right atrial thrombus complicated by severe pulmonary embolism treated successfully by low molecular weight heparin.