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Figure 2 M-mode (top), continuous wave (middle), and pulsed wave Doppler (bottom) tracings of two patients. Patient 3 is on the left and patient 14 is on the right. In both patients, the left dashed line indicates time of Q-wave onset. The right solid line indicates the time of SAM onset. In both patients SAM onset begins at a time of low velocity both in the outflow tract and in the LV. In both patients SAM begins before the onset of ejection, during the Ar wave (16–19). Both M-mode and Doppler tracings were recorded on the same study, within a 5-min interval, and were selected for matched RR intervals. Vertical calibrations of CW and PW tracings are at 1-m/s and 20-cm/s intervals, respectively.