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Figure 4 (Left) Transesophageal echocardiography of left ventricular outflow tract showing sub-valvular membrane (arrow). (Right) Continuous wave signal of abnormal flow. Note the early peaking with a gradient of almost 100 mm Hg and the presence of aortic regurgitation. Both are unexpected with dynamic obstruction. AV = aortic valve; LA = left atrium; LV = left ventricle.