about 50 y old patient with septic shock. A genetic defect is known. There exists no documents of clinical history. In Part 1 you can see the transthoracal echocardiography: we could see an ASD, a VSD. There is no sign of AV-canal or a stenosis of the pulmonary valve. Furthermore we see a distinct hypertrophy of the right cavum (about 14-15 mm; by comparison with the left ventricular: 12-13 mm).