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A woman presented with acute left leg pain requiring urgent left femoral embolectomy. Echocardiography showed a large, pedunculated left ventricular mass, but no additional cardiac abnormality. Clinical evaluation including cardiac catheterization and open heart surgery demonstrated no cardiac pathologic findings. At surgery, a large thrombus was removed from the left ventricle. We suggest that all patients with arterial embolic disease have echocardiography, even if heart disease is not suspected. (Chest 1989;96:426–27)