Which of the following accurately describes the murmur associated with aortic stenosis?

• A. Systolic crescendo-decrescendo murmur
• B. Diastolic decrescendo murmur
• C. Continuous murmur
• D. Midsystolic click

Answer: (D)

The murmur of aortic stenosis is a systolic ejection murmur that has a crescendo-decrescendo shape. It is best heard at the right upper sternal border and commonly radiates to the carotids. Its timing spans from after S1 to before S2, and the peak shifts with severity—becoming later in systole as the stenosis worsens. A helpful clue is the sometimes soft or delayed carotid pulse (pulsus parvus et tardus).

Diastolic decrescendo murmurs point to regurgitant lesions, not AS. A continuous murmur suggests conditions like a patent ductus arteriosus. A midsystolic click is characteristic of mitral valve prolapse.