Aortic stenosis ( early) / & AS- late
Murmur:
- Harsh late-peaking crescendo-decrescendo systolic murmur
- Heard best- left 2nd ICS
- Radiation to the carotids.
Possible associated findings:
- Abnormal carotid pulse
- Diminished and delayed ("pulsus parvus and tardus")
- Sustained Apical impulse
- Calcified aortic valve on CXR
Murmur:
- Blowing holosystolic murmur
- Heard best at the apex
- Radiation to the axilla and inferior edge of left scapula.
Possible associated findings:
- S2: wide physiologic splitting
- S3
Murmur:
- Harsh crescendo-decrescendo systolic murmur
- Heard best sternal border bat 2nd or 3rd intercostal spaces
- Increases with inspiration
Associated findings:
- Ejection sounds heard at sternal edge, 2nd or 3rd intercostal space
- Wide physiological splitting of S2
- Prominent A wave of the jugular venous pulse
Murmur:
- Soft blowing early diastolic decrescendo murmur
- Heard best at the left 2nd ICS without radiation
- May also hear systolic flow murmur and diastolic rumble (Austin Flint)
Possible associated findings:
- Dilated apical impulse
- Abnormal and collapsing arterial pulses
Murmur:
- Low frequency rumbling mid-diastolic murmur, with presystolic component possible
- Heard best at apex
- Accentuated in left lateral decubitus position
Associated findings:
- Apical impulse absent or small
- Irregular pulse ( atrial fibrillation)
- Loud S1
- Elevated neck veins with exaggerated A wave
Listen for normal heart sounds:
- The 1st heart sound, S1 (lub), marks the beginning of systole (end of systole).
- Related to the closure of the mitral and tricuspid valves.
- Loudest at the apex.
- The 2nd hear sound, S2 (dub), marks the end of systole (beginning of diastole).
- Related to the closure of the aortic and pulmonic valves.
- Loudest at the base.
