Echocardiogram in apical four chamber view shows severe tricuspid regurgitation (TR) as a large mosaic (multi-colored) jet filling more than half of a dilated right atrium (RA). Right ventricle (RV) is also dilated. Tricuspid valve (TV) and mitral valve (MV) are in the closed position. A large part of the interatrial septum is missing, though it is not easy to comment on interatrial septum in this view as the septum is parallel to the ultrasound beam. An echo dropout in the interatrial septum is quite common in the apical four chamber view especially at the site of foramen ovale where the septum is thin.