Harsh systolic murmur along the right sternal border. What is the most likely diagnosis?

Study for the PANCE Cardiology Test. Enhance your knowledge with comprehensive flashcards and multiple-choice questions. Each question comes with hints and detailed explanations. Prepare thoroughly for your exam!

Multiple Choice

Harsh systolic murmur along the right sternal border. What is the most likely diagnosis?

A harsh systolic murmur heard best at the right upper sternal border points to aortic stenosis. The right 2nd intercostal space corresponds to the aortic valve area, and the high-velocity jet through a narrowed valve produces a harsh, crescendo-decrescendo murmur that often radiates to the carotids. In significant AS, the carotid pulse may be delayed and diminished (parvus et tardus). By contrast, mitral regurgitation is a holosystolic murmur best at the apex radiating to the axilla; aortic regurgitation is a diastolic decrescendo murmur best along the left sternal border; pulmonary stenosis is best heard at the left upper sternal border. Therefore, this presentation most strongly suggests aortic stenosis.

A harsh systolic murmur heard best at the right upper sternal border points to aortic stenosis. The right 2nd intercostal space corresponds to the aortic valve area, and the high-velocity jet through a narrowed valve produces a harsh, crescendo-decrescendo murmur that often radiates to the carotids. In significant AS, the carotid pulse may be delayed and diminished (parvus et tardus). By contrast, mitral regurgitation is a holosystolic murmur best at the apex radiating to the axilla; aortic regurgitation is a diastolic decrescendo murmur best along the left sternal border; pulmonary stenosis is best heard at the left upper sternal border. Therefore, this presentation most strongly suggests aortic stenosis.

More practice questions