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In two patients, women of 35 and 74 years old, paradoxical embolism was diagnosed. Patient A presented with multiple pulmonary embolism. Transoesophageal echocardiography demonstrated a thrombus mass which protruded from the right atrium through a patent foramen ovale into the left atrium: explicit proof of the possibility of paradoxical embolism. Patient B presented with systemic arterial embolism. During hospitalisation multiple pulmonary embolism occurred. With the use of transoesophageal contrast echocardiography a patent foramen ovale was observed, the probable cause of paradoxical embolism. Both patients were treated with intravenous heparin and oral anticoagulants.