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Subsequent imaging demonstrated embolisation to the brain in the setting of elevated right atrial pressures and the presence of a patent foramen ovale (PFO) with right-to-left shunting. We employed a strategy of percutaneous closure of PFO, to prevent further embolisation, as a successful bridge to definitive surgical management of RSIE. We emphasise that clinicians should evaluate for intracardiac shunting and pursue transesophageal echocardiography when encountering systemic emboli of unknown origin, particularly in patients with RSIE.<\/jats:p>","DOI":"10.1136\/bcr-2022-250272","type":"journal-article","created":{"date-parts":[[2022,5,27]],"date-time":"2022-05-27T10:35:17Z","timestamp":1653647717000},"page":"e250272","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":9,"title":["Paradoxical embolisation in right-sided infective endocarditis and patent foramen ovale"],"prefix":"10.1136","volume":"15","author":[{"given":"Tyler T","family":"Shimfessel","sequence":"first","affiliation":[{"name":"Internal Medicine, University of Kentucky Medical Center, Lexington, Kentucky, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sami A","family":"El-Dalati","sequence":"additional","affiliation":[{"name":"Internal Medicine, University of Kentucky Medical Center, Lexington, Kentucky, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Sekela","sequence":"additional","affiliation":[{"name":"Cardiothoracic Surgery, University of Kentucky Medical Center, Lexington, Kentucky, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1337-7689","authenticated-orcid":false,"given":"Taha","family":"Ahmed","sequence":"additional","affiliation":[{"name":"Internal Medicine, University of Kentucky Medical Center, Lexington, Kentucky, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2022,5,27]]},"reference":[{"key":"2025082707204283000_15.5.e250272.1","doi-asserted-by":"crossref","DOI":"10.1136\/heart.89.11.1362","article-title":"Learning on the web. 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