Which finding is typical of an aortic stenosis murmur?

Which finding is typical of an aortic stenosis murmur?

• A. Crescendo-Decrescendo murmur radiating to the carotids with a harsh and delayed carotid upstroke
• B. Murmur that increases with inspiration
• C. Diastolic blowing murmur at left sternal border
• D. Continuous murmur best heard at the left infraclavicular region

Answer: (A)

Aortic stenosis produces a systolic ejection murmur that is crescendo-decrescendo and typically harsh in quality. It is best heard at the right upper sternal border and commonly radiates to the carotids because the high-velocity jet across the narrowed aortic valve sends turbulent flow up into the aortic root and carotid arteries. The carotid pulse is characteristically delayed and diminished—a sign known as pulsus parvus et tardus—reflecting reduced left ventricular ejection during LV systole. This combination—systolic timing, harsh crescendo-decrescendo quality, radiation to the carotids, and a delayed carotid upstroke—makes the finding classic for aortic stenosis. Murmurs that increase with inspiration point to right-sided events, which is not a feature of aortic stenosis. A diastolic blowing murmur at the left sternal border indicates aortic regurgitation, not stenosis, and is heard in diastole rather than systole. A continuous murmur best heard at the left infraclavicular region suggests a patent ductus arteriosus or similar continuous flow disturbance, not AS.

Aortic stenosis produces a systolic ejection murmur that is crescendo-decrescendo and typically harsh in quality. It is best heard at the right upper sternal border and commonly radiates to the carotids because the high-velocity jet across the narrowed aortic valve sends turbulent flow up into the aortic root and carotid arteries. The carotid pulse is characteristically delayed and diminished—a sign known as pulsus parvus et tardus—reflecting reduced left ventricular ejection during LV systole. This combination—systolic timing, harsh crescendo-decrescendo quality, radiation to the carotids, and a delayed carotid upstroke—makes the finding classic for aortic stenosis.

Murmurs that increase with inspiration point to right-sided events, which is not a feature of aortic stenosis. A diastolic blowing murmur at the left sternal border indicates aortic regurgitation, not stenosis, and is heard in diastole rather than systole. A continuous murmur best heard at the left infraclavicular region suggests a patent ductus arteriosus or similar continuous flow disturbance, not AS.