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We describe an unusual case of a large aortopulmonary window which was not very symptomatic and presented as Eisenmenger syndrome at the age of 20 years in a male patient. We take this opportunity to highlight some of the basic investigations like chest X-ray and contrast echocardiography which can delineate the level of the shunt. Attention should be given to the subtle bedside clinical signs which can give clues to the diagnosis. We did a cardiac computed tomography scan for confirmation of the diagnosis.