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The left ventricle becomes D-shaped, which is a sign of increased preload in the right ventricle (RV) displacing the septum toward the left. Septal flattening is best appreciated in the short-axis view at the level of papillary muscles (basal or .
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The “D Sign” is an ultrasound/echo finding that shows the left ventricle as a D-shaped structure. It is a result of right ventricular overload causing a shift of the septum towards the left side of the heart. The “D-sign” can be the result of either right ventricular Pressure and/or Volume overload.
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