The kid was affected by mitral and tricuspid dysplasia resulting in atrial systolic regurgitation demonstrated by an atrial dilation an increase of the ratio between the lelf atrium diameter and the aortic root diameter to 3.61. The mitral and the tricuspid valve regurgitation determines the volume overloading of the lelf and or right side of the heart and subsequently pulmonary and or systemic congestion.Chronic volume overload of the ventricle results in eccentric hypertrophy of the involved chamber which could decrease the contractility of the myocardium and cause the clinical finding of lelf or right heart fail