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Parasternal short-axis views at the mid-ventricular level. (A and B) Patient with atrial septal defect type ostium secundum, consequent right ventricular volume overload, and mildly elevated pulmonary artery pressures—flattening of the interventricular septum at end diastole (A) and recovering of shape at end systole (arrow) (B). (C and D) Patient with severe pulmonary arterial hypertension and consequent severe right ventricular pressure overload—flattening of the interventricular septum both at end diastole (C) and end systole (arrow) (D).