This 56 year old smoker with a history of HIV and anal cancer presents with complaints of 1 month of gradual onset severe shortness of breath, much worse for the past week. Vitals: 82/46 130 98.6F 30 75%RA.

A 73 year old female presents with sudden onset of midsternal chest pain and shortness of breath. The pain is worse with deep respiration and does not radiate. The patient appears to be in severe pain and is diaphoretic.  BP 82/45 P 74 O2 sat 95% RA.

37 yo female presents with complaints of increasing generalized malaise over the past 2 weeks as well as a fever and nausea. She endorses a history of intravenous drug use (IVDU). On physical exam, you appreciate a faint systolic murmur. Before any lab tests or other imaging have been done, you obtain the following echo:

This 56 year old male presents with right sided hemiparesis and expressive aphasia. What finding here could be the origin of these symptoms?