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The correct answer is C, pulmonary hypertension. The M-mode illustrated is through the pulmonic valve and reveals notching of the pulmonic valve leaflet, with a characteristic flying W sign. Also note the absence of an 'A dip in the pulmonic valve tracing. This differentiates the M-mode from pulmonic stenosis in which there is an exaggerated 'A dip. The M-mode is through the pulmonic valve and as such, cannot reveal tricuspid regurgitation or Ebstein's abnormality. There is no characteristic finding on pulmonic valve M-mode in right bundle branch block



Author: Atif Qasim, MD FASE
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