Atrial septal defect (ASD) with bidirectional shunt Atrial septal defect (ASD) with bidirectional shunt: Subcostal four chamber view shows a large defect in the interatrial septum (ASD). Right
Subcostal four chamber view – Echocardiography Subcostal four chamber view is excellent for visualization of interatrial septum. If an atrial septal dropout is seen in the apical four