Intracardiac thrombus and pulmonary embolism with cavitation and pneumomediastinum in a patient with protein S deficiency

We present a case of intracardiac thrombus with pulmonary embolism and pulmonary infarction in a patient with protein S deficiency. Secondary infection of the pulmonary infarction resulted in pneumomediastinum. Thrombus in an unusual location in a young patient without known predisposing conditions is a characteristic feature of a hereditary thrombophilic disorder. Cavitation within a lesion adjacent to the mediastinal pleura can result in pneumomediastinum.