Echocardiographic signs of LBBB M-mode: shows paradoxical septal motion — the septum moves inward early and then outward later in systole. 2D echo: demonstrates septal flash (brief early septal contraction), apical rocking (side-to-side movement of the apex), and delayed lateral wall contraction. Doppler: shows prolonged LV pre-ejection period and interventricular mechanical delay (aortic flow starts much later than pulmonary flow). Tissue Doppler (TDI): reveals septal-to-lateral delay in peak s
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