Right heart acoustic imaging can be used to diagnose patent foramen ovale and pulmonary arteriovenous fistulae. The prevalence of patent foramen ovale is actually quite high, reaching about 30% in the population, with 3 out of 10 people suffering from patent foramen ovale, and patent foramen ovale is asymptomatic and generally does not require any specific treatment. A small number of patients with patent foramen ovale combine with migraines and young strokes. If recurrent migraines occur and no other cause can be found, it is important to consider whether patent foramen ovale is the cause. Young stroke patients also need to consider whether there is a combination of patent foramen ovale because there are risk factors for stroke, such as hypertension, hyperlipidemia, and diabetes mellitus. However, sometimes we find that a young patient suddenly develops a cerebral embolism without hypertension, diabetes mellitus, or hyperlipidemia, and the embolus may originate from a venous thrombus in the lower extremities, which enters the cerebral arteries through the patent foramen ovale to form a stroke, which is then excluded from the treatment of patent foramen ovale. The patent foramen ovale needs to be excluded. On right heart acoustic imaging, the presence of microbubbles in the left heart soon after the right heart microbubbles have filled is suggestive of patent foramen ovale, and the diagnosis is usually made within 3 cardiac cycles. If microbubbles appear in the left heart after the right heart microbubbles have filled and after 5 cardiac cycles, the possibility of a pulmonary arteriovenous fistula is usually considered.