Guide To Heart Murmurs: Aortic Stenosis Murmur

OVERVIEW

This page is dedicated to characterizing an aortic stenosis murmur. Descriptions of other murmurs can be found here.

WHAT IS IT?

An aortic stenosis murmur is a fairly self descriptive medical term. It is a murmur that is is caused by the narrowing of the aortic valve. 

Turbulent blood flow, caused by narrowing of the aortic valve is responsible for causing an aortic stenosis murmur (source).
WHAT CAUSES IT?

This heart murmur can be caused by any process that narrows the aortic valve:

  • Calcification of the aortic valve 
FEATURES OF AUSCULTATION

Where to listen: this murmur is typically heard best at the heart base (aortic region) and it can radiate to the carotid arteries (radiates to the neck).

Classically an aortic stenosis murmur is heard best over the aortic region of the chest, and can radiate up into the neck (source)

When to listen: this is a systolic murmur and can be best appreciated during systole (begins after S1 and ends before S2)

What to listen for: typically this murmur is described as a crescendo decrescendo murmur. An ejection click may also be present.

This figure represents the classic crescendo-decresendo nature of an aortic stenosis murmur. The volume of the murmur will increase and decrease as the pressure of the left ventricle changes relative to the pressure in the aorta (source)
IMPACT OF BEDSIDE MANEUVERS ON THIS MURMUR

Various bedside movements can be performed that can help inform what type of murmur is present. The following maneuvers will have the listed effects on an aortic stenosis murmur:

  • Valslava will cause the murmur intensity to decrease (decreases pre-load)
  • Standing up will cause the murmur intensity to decrease (decreases pre-load)
  • Rapid squatting will cause the murmur intensity to increase (increases pre-load)

 

 

Page Updated: 01.24.2017