In the 4-chamber view of the heart, the atrioventricular (AV) valves are offset, with the anterior AV valve (tricuspid valve) inset closer to the apex of the heart and the mitral valve set back closer to the base. When an atrioventricular septal defect is present, the offset of AV valves is not seen, and the valves have the appearance of a pair of bird wings flapping in parallel. Another cardiac abnormality, where you will see a difference in this offset, is Ebstein’s anomaly, where the tricuspi