73yo man, with a history of hypertension and coronary disease, is brought into the emergency room after a witnessed syncopal episode at home. He reported some mild exertional chest pain over the past few days, but states that it improved with rest. Vital signs are BP-180/98, HR-74, RR-12, and O2-100%. He is currently in no distress and not diaphoretic. Physical examination revealed a systolic murmur over the 2nd right intercostal space. A CT was ordered to rule-out PTE in the setting of chest pain and syncope and is below, along with the murmur.
- What is the diagnosis?
- How would you describe this murmur?
- Where would you expect this murmur to radiate?
- What is the classic triad associated with this condition?
- Aortic Stenosis due to a calcified aortic valve
- High-pitched, crescendo-decrescendo (diamond shaped), midsystolic, ejection murmur with a soft S2
- AS murmurs transmit well and equally to the carotid arteries
- The classic triad of AS is exertional angina, exertional dyspnea, and dizziness/syncope