We discuss a case of a 20-year-old woman presenting with chest pain found to 
have a Hampton's hump on chest x-ray and corresponding wedge infarct on computed 
tomographic scan. Contrary to our suspicion that this febrile and tachycardic 
patient had a pulmonary embolism, she was later determined to have a septic 
embolus secondary to endocarditis. We highlight the difficulties in diagnosing 
certain cases of endocarditis in the emergency department, as well as the 
difficulties in distinguishing septic emboli from pulmonary emboli,especially 
with plain radiographs.