Tiger stripes sign is the high amplitude band-like signal noted on Doppler spectral recordings of valvular regurgitation. This is noted most often in patients with porcine mitral prosthetic valves and may be indicative of flail prosthetic leaflet. We herein describe a patient with tiger stripes signin a severe mitral regurgitation on native valve associated with Ostium secundum atrial septal Defect (ASD).  Case summary A 41-year-old woman hospitalized for progressively worsening exertional dyspnea NYHA (New York Heart Association) class III associated with chest pain evolving for the past 3 years. The patient’s medical history includes Grave’s disease. Clinical examination revealeda grade 5/6 blowing holosystolic murmur at the apex and a grade 4/6 blowing murmur at the tricuspid area.ECG showed trial Fibrillation. Echocardiography showed the presence of severe mitral regurgitation Figure 1: (A), severe tricuspid regurgitation and secundum atrial septal defect with 10 mm diameter. Doppler showed the appearance of tiger stripes sign in continuous-wave doppler (CW) and in pulsed-wave doppler (PW) on the mitral valve. Figure 1: (B,C).