Cyanotic congenital heart disease is often diagnosed in infancy.Here we present a case of a 19-year-old female who presented with abdominal pain, hypoxia and clubbing. She was found to have a splenic infarct on CT scan. The splenic infarct was caused by an emboli from the right side of the circulation that traveled across a communication between the right pulmonary artery and the left atrium. This lesion has only been cited in 23 adult cases [1]. When the communication was identified on transthoracic echocardiogram, she was diagnosed with cyanotic congenital heart disease and the etiology for her clubbing was discovered.