Double-chambered right ventricle is a rare congenital heart disorder involving 2 different RV pressure compartments that is often associated with malalignment VSD. Usually, the obstruction is caused by an anomalous muscle bundle crossing the RV from the interventricular septum to the RV free wall. We emphasize that an increased tricuspid regurgitant gradient, as measured by continuous-wave Doppler, may be caused by a double-chambered right ventricle and not by pulmonary hypertension.