A 56 year old male has a history of aortic stenosis. Which of the following is associated with aortic stenosis?
a) Atrial fibrillation
b) Systolic ejection murmur
c) Increased pulse pressure
d) Diastolic murmur
e) Right heart failure
The correct answer is B
With aortic stenosis there is a systolic ejection murmur that is heard loudest at the second right intercostal space (the aortic area). A systolic ejection murmur is also seen with pulmonic stenosis, however this is best heard in the second left intercostal space. Atrial fibrillation is common in mitral stenosis. It is also seen in mitral regurgitation, however, less commonly than with mitral stenosis.
Aortic stenosis typically is not associated with atrial fibrillation.The pulse pressure is the difference between systolic and diastolic pressure. An increased pulse pressure is seen with aortic regurgitation.
It manifests itself with various signs: Quincke’s sign, Duroziez’s sign and a ‘water hammer pulse‘. Diastolic murmur is heard with several different valvular conditions, including aortic regurgitation.
A diastolic murmer is not heard with aortic stenosis. The murmur of aortic stenosis is heard during systole.The symptoms of aortic stenosis include left ventricular failure (syncope and angina are also symptoms).