Introduction
Pulmonary embolism (PE) is a medical condition usually managed with anticoagulation or thrombolysis, however in certain cases surgical management can be considered as the best therapeutic intervention1. Floating aortic thrombus can lead to catastrophic systemic embolism and operative management prevents this complication2,3. Several reports of successful systemic anticoagulation alone have been reported. Concomitant presentation of both conditions poses extra challenge to clinical decision making to ensure the best possible outcome.