A 65-year-old woman with paradoxical embolism of the left brachial artery, deep vein thrombosis of the lower extremities, pulmonary embolism and patent foramen ovale (PFO) is reported. She experienced right tibia fracture a month prior to admission to the hospital and a plaster split was applied. Clinical deterioration was observed 3 weeks later with dyspnea, pain, numbness and absence of motions in the left arm. Occlusive thrombus in the left brachial artery was diagnosed that required its removal. Doppler ultrasound of the lower extremity veins revealed thrombosis of the right popliteal vein. Transthoracic and transesophageal echocardiography revealed patent foramen ovale with a thrombus in the right atrium penetrating into the left atrium through the PFO. The thrombus prolapsed into the chambers of the left and right ventricles. En-bloc removal of this thrombus was associated with thrombectomy from the pulmonary artery and atrial septal defect closure. Postoperative period was uneventful. The patient was discharged in satisfactory condition.