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. Author manuscript; available in PMC: 2010 Jun 5.

Published in final edited form as: J Am Soc Echocardiogr. 2009 Jan;22(1):53–59. doi: 10.1016/j.echo.2008.10.020

A TTE study was ordered by a surgeon for a 39-year-old man with no significant cardiovascular symptoms for an indication of preoperative assessment (unclassifiable in the appropriateness criteria). (A) Modified short-axis view of the base of the heart. A left-to-right turbulent color jet was noted across the interatrial septum. (B) Right ventricular enlargement on an apical 4-chamber view and the same color jet in the area of a secundum atrial septal defect (right). Right ventricular systolic function was normal. Shunt fraction (Qp/Qs) was calculated to be 1.8. View video clip online.

Inline graphic — A TTE study was ordered by a surgeon for a 39-year-old man with no significant cardiovascular symptoms for an indication of preoperative assessment (unclassifiable in the appropriateness criteria). (A) Modified short-axis view of the base of the heart. A left-to-right turbulent color jet was noted across the interatrial septum. (B) Right ventricular enlargement on an apical 4-chamber view and the same color jet in the area of a secundum atrial septal defect (right). Right ventricular systolic function was normal. Shunt fraction (Qp/Qs) was calculated to be 1.8. View video clip online.