QuestionSBA
QuestionChoice
This patient has symptoms of aortic valve stenosis. Angina occurs due to reduced perfusion through the aorta and into the coronary arteries of the heart. Syncope occurs due to reduced perfusion of oxygenated blood to the brain via the internal carotid arteries (branches of the aortic arch). The patient is also 86 years old, which may suggest a senile calcification or fibrosis of this patient's aortic valve, resulting in stenosis. The aortic valve is auscultated on the right 2nd intercostal space on the sternal edge.
10007790
a
Ejection-systolic murmur on the right 2nd intercostal space sternal edge
QuestionChoice
This patient has symptoms of aortic valve stenosis. This option describes the correct murmur, but this is the incorrect location of the aortic valve.
10007791
b
Ejection-systolic murmur on the left 2nd intercostal space sternal edge
QuestionChoice
This is the incorrect murmur. A mid-diastolic murmur is often seen in mitral valve stenosis, which is likely to cause symptoms of pulmonary oedema (dyspnoea) or dysphagia, due to compression of the oesophagus.
10007793
d
Mid-diastolic murmur on the left 4th intercostal space sternal edge
QuestionChoice
This is the incorrect murmur. An early diastolic murmur is often seen in aortic valve regurgitation, which is likely to cause an increased systolic pressure and a decreased diastolic pressure, which is not seen in this patient. The patient may also present with a bounding pulse such as Quinke's sign (visible capillary pulsations following light compression applied to the tip of the fingernail bed) and head bobbing.
10007794
e
Early diastolic murmur on the right 2nd intercostal space sternal edge
QuestionChoice
This is the incorrect murmur. A mid-diastolic murmur is often seen in mitral valve stenosis, which is likely to cause symptoms of pulmonary oedema (dyspnoea) or dysphagia, due to compression of the oesophagus.
10007792
c
Mid-diastolic murmur on the left 5th intercostal space mid-clavicular line
Concept
Chapter
2693
3716
Aortic stenosis
Topic
134
Cardiology
14105
An 86-year-old man presents to the GP with central chest pain that occurs when he is walking around, and three episodes of 'blacking out'. The patient has no other signs and symptoms currently. On auscultation of the patient's heart valves a murmur is detected.

Blood Pressure: 108/72 mmHg

Heart Rate: 89 bpm

JVP: 7.5 cm H2O (6 - 8 cm H2O)

Stroke Volume: 54 mL/beat

End Diastolic Volume = 120 mL/beat

Which of the following auscultation findings is most likely to be heard?
a