A 40 year old female patient presented with on and off episodes of breathlessness. Clinically there is evidence of raised Jugular venous pressure (JVP), peripheral pitting edema and tender hepatomegaly suggestive of right heart failure. Blood pressure is normal. Tachycardia is noted with normal heart rhythm. Echocardiographic examinations were done on an HD7 Philips diagnostic ultrasound system, Bothell, Washington, USA. Echocardiographic findings are ostium secundum atrial septal defect (ASD) measuring 1.1 cm along with thickened mitral valve leaflets (MV), doming and mitral stenosis (1.1 sq. cm) with dilatation of the right atrium (RA) and right ventricle (RV).