Patent Foramen Ovale

 

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Example 1: PFO with left to right flow.
This is bicaval TEE view of the intra-atrial septum with color Doppler. 
There is predominantly left to right flow across this PFO. Note that with inspiration, right sided pressure increases, the intra-atrial septum bows to the left  atrium (toward the top right of this video) and the left to right flow decreases.
In states where there are transient increases in right-sided pressure there can be right to left flow, [note the small amount of orange colored flow] which is one mechanism for paradoxical embolism.