Fig. 2

A Apical 5 Chamber view of sub-aortic membrane (red arrow). B Spectral doppler illustrating a calculated Aortic Valve Area = 0.82cm². C CW spectral doppler suggestive of significant aortic stenosis and mild to moderate regurgitation. B & C Also shows an approximate VSD velocity of 4 m/sec. D Color doppler in an Apical view showing flow across a membranous ventricular septal defect (VSD). E Short axis view at aortic valve level showing flow across a membranous VSD. F Spectral doppler of tricuspid regurgitation (RVSP = SBP- 4[VSD velocity]²) = 160–64 = 96 mmHg. G Subcostal color doppler of VSD, H Pulse-wave doppler of LVOT (PW). I Tricuspid Aortic valve on PSAX, aortic valve level. J Right ventricular systolic pressure (RVSP = SBP- 4[VSD velocity]²) = 160–64 = 96 mmHg. K Moderate concentric LVH in diastole with Systolic Anterior Motion (SAM) of mitral valve. L Moderate concentric LVH in systole. M Discrete crescent shaped membrane below the aortic valve cups. N Sample volume placed after the valve. O Sample volume placed after the membrane