Which of the following physical signs is seen in a patient with severe aoic stenosis
The murmur of AS is characteristically an ejection (mid) systolic murmur that commences sholy after the S 1 , increases in intensity to reach a peak toward the middle of ejection, and ends just before aoic valve closure . It is characteristically low-pitched, rough and rasping in character, and loudest at the base of the hea, most commonly in the second right intercostal space. It is transmitted upward along the carotid aeries. Occasionally it is transmitted downward and to the apex, where it may be confused with the systolic murmur of MR (Gallavardin effect). ( Harrison&;s principle of internal medicine,18th edition,pg no.1939 )
Opening snap
Diastolic rumble
Holosystolic murmur
Delayed peak of systolic murmur
C.V.S