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Severe Aortic Stenosis Lesson

Virtual Auscultation

patient torso with stethoscope chestpiece

patient position during auscultation
The patient's position is sitting.


In severe aortic stenosis, there is a diamond-shaped systolic murmur continuing through systole. The murmur is loud and higher pitched than a mild aortic stenosis murmur.

S1 is normal. S2 is louder than normal. In fact, you are hearing only the accentuated pulmonic component of S2 due to heart failure on the left side. The aortic ejection click heard in mild cases of valvular aortic stenosis is gone. A fourth heart sound can often be heard in late diastole. This is caused by the increased left ventricular wall thickness and stiffness.

Calcification of the aortic valve leaflets is a cause of this murmur. When viewing the cardiac animation, look for a greatly thickened left ventricular wall and the almost totally immobile aortic leaflets.


Heart Sounds Video

Authors and Sources

Authors and Reviewers


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