A 75-year-old man is brought to the casualty with sudden syncopal episode while playing with his grandchildren. He is currently ale and describes occasional substernal heaviness and shoness of breath. His lungs have bibasilar rales and BP is 120/80mmHg. Which is the classical finding expected in this patient?
The clinical presentation of exeional syncope, angina equivalent and dyspnea in geriatric age group points to diagnosis of valvular Aoic stenosis. The auscultatory finding is of harsh ejection systolic murmur radiating to the carotids. Soft S2 is due to poor mobility of a stenosed valve. Choice B is wrong because in aoic stenosis, narrow split S2 or paradoxical split S2 is heard. Choice C and D are wrong due to presence of Ejection systolic murmur in aoic stenosis.
Ejection systolic murmur with Soft S2
Ejection systolic murmur with wide split S2
Harsh Holosystolic murmur with soft 2
Harsh pan-systolic murmur with loud S2
Hea Sounds