Physical-exam-aortic-stenosis
- Midsystolic crescendo-decrescendo murmur at RUSB,
- harsh, high-pitched, radiates to carotids, apex (holosystolic = Gallavardin effect),
- ↑ w/ passive leg raise,
- ↓ w/ standing & Valsalva.
- Dynamic outflow obstruction (HCM) is the reverse.
- Ejection click after S1 sometimes heard with bicuspid AoV
- Signs of severity:
- late-peaking murmur,
- paradoxically split S2 or inaudible A2,
- small and delayed carotid pulse (“pulsus parvus et tardus”),
- LV heave, ⊕ S4 (occasionally palpable)
