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The Eustachian valve (EV) is an embryonic remnant of the sinus venosus. In adults, this structure may be completely absent or it may appear as a thin flap on echocardiography. However, in some patients, it may persist as a long mobile structure in the right atrium, and simulate structural cardiac defects. This case report intends to increase awareness that a giant EV can be mistaken as interatrial septum, leading to a misdiagnosis of patent foramen ovale and can lead to potentially major deleterious consequences. A comprehensive transesophageal echocardiographic examination in multiple views and knowledge of jet direction across the defects will help us in avoiding misdiagnosis of cardiac structures.