How do you describe aortic stenosis murmur?

Aortic stenosis is associated with an ejection systolic murmur heard loudest over the aortic valve. The murmur is described as having a ‘crescendo-decrescendo’ quality (it appears as diamond-shaped on a phonogram). The murmur of aortic stenosis commonly radiates to the carotid arteries.

What is characteristic of aortic stenosis?

Aortic valve stenosis causes a thickening and narrowing of the valve between the heart’s main pumping chamber (left ventricle) and the body’s main artery (aorta). The narrowing creates a smaller opening for blood to pass through. Blood flow from the heart to the rest of the body is reduced or blocked.

What is the classic triad of symptoms in aortic stenosis?

Symptoms of aortic stenosis usually develop gradually after an asymptomatic latent period of 10-20 years. Exertional dyspnea or fatigue is the most common initial complaint. Ultimately, most patients experience the classic triad of chest pain, heart failure, and syncope (see History).

What are the characteristics of murmur in mitral stenosis?

The diastolic murmur of mitral stenosis is of low pitch, rumbling in character, and best heard at the apex with the patient in the left lateral position. It commences after the opening snap of the mitral valve, and the duration of the murmur correlates with the severity of the stenosis.

What kind of murmur is heard with aortic stenosis?

The typical murmur of aortic stenosis is a high-pitched, “diamond shaped” crescendo-decrescendo, midsystolic ejection murmur heard best at the right upper sternal border radiating to the neck and carotid arteries (see figure below). In mild aortic stenosis, the murmur peaks in early systole.

Is aortic stenosis a diastolic murmur?

Diastolic murmurs include aortic and pulmonic regurgitation (early diastolic), and mitral or tricuspid stenosis (mid-late diastolic). Tricuspid stenosis is very rare and is discussed further in the valvular heart disease section.

Why is aortic stenosis a systolic murmur?

As aortic stenosis worsens, it takes longer for blood to eject through the valve, so the peak of the crescendo-decrescendo murmur moves to later in systole. Thus, mild aortic stenosis would have an early peaking murmur while the murmur of severe aortic stenosis peaks later in systole.

Why does aortic stenosis murmur increases with squatting?

The murmur of mitral valve prolapse may shorten with squatting, although as mitral regurgitation becomes more severe, the murmur may increase in intensity with squatting due to increase in afterload. Most murmurs decrease in intensity during the Valsalva maneuver.

Why does aortic stenosis have a murmur?

The murmur occurs because the aortic valve is narrowed and stiff, and cannot completely open to allow healthy blood flow out of the left ventricle and into the aorta. In many cases, the sound of aortic stenosis murmur is the first sign of aortic valve stenosis.

How do you examine aortic stenosis?

Tests for aortic valve stenosis may include:
  1. Echocardiogram. …
  2. Electrocardiogram (ECG or EKG). …
  3. Chest X-ray. …
  4. Exercise tests or stress tests. …
  5. Cardiac computerized tomography (CT) scan. …
  6. Cardiac magnetic resonance imaging (MRI) scan. …
  7. Cardiac catheterization.

Which of the following physical exam findings suggests aortic stenosis?

A classic physical finding of aortic stenosis is a harsh, crescendo-decrescendo systolic murmur that is loudest over the second right intercostal space and radiates to the carotid arteries.

Where is aortic stenosis murmur heard best?

Classically, the aortic stenosis murmur is heard best at the right upper sternal border (where it is harsh and noisy). It radiates to the right supraclavicular area. (Lack of radiation to this area should raise the question of another cause for the murmur.)

Why second heart sound soft in aortic stenosis?

The S2 heart sound intensity decreases with worsening aortic stenosis due to immobile leaflets. In severe aortic stenosis, the A2 component may not be audible at all.

What does an aortic murmur sound like?

Heart murmurs are sounds — such as whooshing or swishing — made by rapid, choppy (turbulent) blood flow through the heart. The sounds can be heard with a device called a stethoscope. A typical heartbeat makes two sounds like “lubb-dupp” (sometimes described as “lub-DUP”) when the heart valves are closing.

What does aortic stenosis sound like with a stethoscope?

Aortic stenosis: Murmur: Harsh late-peaking crescendo-decrescendo systolic murmur. Heard best- left 2nd ICS.

What are right and left sided murmurs?

Respiration: right-sided murmurs tend to be louder on inspiration, left-sided murmurs tend to be louder on expiration. This can be remembered with R-I-L-E (right on inspiration, left on expiration).

How do you know if a murmur is systolic or diastolic?

What is the difference between a diastolic and systolic murmur? A diastolic murmur occurs when your heart relaxes between heartbeats. Diastolic murmurs are often harder to hear than systolic murmurs. A systolic heart murmur occurs when your heart muscle contracts.

What are the four types of heart murmurs?

What are the different types of murmurs?
  • Systolic murmur. This happens during a heart muscle contraction. …
  • Diastolic murmur. This happens during heart muscle relaxation between beats. …
  • Continuous murmur. This happens throughout the cardiac cycle.

What are right sided murmurs?

Right-sided murmurs (eg, tricuspid regurgitation) increase with inspiration due to increased venous return to the right heart. Most murmurs diminish in intensity with standing due to reduced venous return to the heart and subsequently reduced right and left ventricular diastolic volumes.