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 borderThe 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.