Medicine>>>>>Cardiology
Question 9#

A 75-year-old patient presents to the ER after a syncopal episode. He is again alert and in retrospect describes occasional substernal chest pressure and shortness of breath on exertion. His blood pressure is 110/80 and lungs have a few bibasilar rales. Which auscultatory finding would best explain his findings?

A. A harsh systolic crescendo-decrescendo murmur heard best at the upper right sternal border
B. A diastolic decrescendo murmur heard at the mid-left sternal border
C. A holosystolic murmur heard best at the apex
D. A mid-systolic click
E. A pericardial rub

Correct Answer is A

Comment:

The classic triad of symptoms in aortic stenosis includes exertional dyspnea, angina pectoris, and syncope. Physical findings include a narrow pulse pressure and systolic murmur. The remaining answers describe aortic insufficiency murmur, mitral regurgitation murmur, mitral valve prolapse click, and a rub associated with pericarditis. These conditions are not associated with syncope as a presenting symptom.