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Describe Valvar Aortic Stenosis Murmurs ?
Characteristic: Harsh, rasping crescendo-decrescendo murmur best heard anywhere in a straight line from right 2nd ICS to apex ("sash" area), with radiation to neck.
Gallaverdin 'Phenomenon: In elderly adults with previously normal tricuspid aortic valves rendered sclerotic or stenotic by fibrocalcific changes, two components of the murmur can be heard a harsh and noisy one over right 2nd ICS which originates within the aortic root due to turbulence caused by high velocity jet and a musical one heard over the left ventricular impulse originating from. The periodic high frequency vibration of fibrocalcific aortic cusps and mimicking the murmur of MR.
The shorter the murmur and later the peak, more severe is the AS in contrast PS where murmur gets longer as stenosis gets more severe. Other auscultatory findings of severe. AS are soft or absent A,, reversed splitting of S, and presence of S4
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