“…When echocardiographic examination fails to detect an intracardiac pathology despite dilatation of the left heart chambers, which is indicative of volume overload, APW should be considered. The communication between the aorta and the pulmonary artery may best be visualised by transthoracic echocardiography at high parasternal short axis (11). High pulmonary arterial pressure and pulmonary vascular resistance may hamper the detection of the defect by colour Doppler and echocardiographic findings may be misinterpreted unless APW is considered in the differential diagnosis (12).…”