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Medicine Murmurs bab784e1

A 68-year-old man presents with progressive shoness of breath. He had a metallic hea valve replacement 13 years ago for severe aoic stenosis. Which of the following clinical findings is most indicative of a failing aoic valve replacement?

A
Clicking sound to S2
B
Early diastolic murmur heard at the left sternal edge
C
New onset atrial fibrillation
D
Ejection systolic murmur heard in the aoic region
High-Yield Explanation
Option B: Early diastolic murmur heard at left sternal edge We know if metallic valves get older & undergo on sheering stress, so there will be backflow of blood from aoa to L.V so early diastolic murmur heard at left sternal edge. Severe aoic stenosis : 1.Transvalvular pressure gradient of > 40 mmHg. 2. Ejection velocity - >4 m/sec 3. Size of orifice - < 0.6 cm2/ m2 BSA

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