AbstractThe echocardiographic patterns of increased right ventricular dimension and abnormal septal motion were observed in a patient with a large pelvic arterio‐venous (A‐V) shunt and no associated cardiac lesion. Although there was evidence of incomplete closure of the shunt four months after surgery, the right ventricular dimension had returned to normal but abnormal septal motion persisted. While these echocardiographic findings cannot be attributed specifically to the shunt in this patient, such a lesion should be considered in patients with these echocardiographic patterns and no cardiac abnormal