the murmur associated with aortic stenosis radiates to the 2nd right intercostal space.
the murmur associated with aortic stenosis radiates to the 2nd right intercostal space.
where does the murmur associated with aortic stenosis radiate?
the 2nd right intercostal space
an easily heard systolic, crescendo-decrescendo (i.e., 'ejection') murmur is heard loudest at the upper right sternal border, at the 2nd right intercostal space, and radiates to the carotid arteries bilaterally. the murmur increases with squatting and decreases with standing and isometric muscular contraction such as the valsalva maneuver, which helps distinguish it from hypertrophic obstructive cardiomyopathy (hocm). the murmur is louder during expiration but is also easily heard during inspiration. the more severe the degree of the stenosis, the later the peak occurs in the crescendo-decrescendo of the murmur.
aortic stenosis
supravalvular aortic stenosis is due to diffuse or discrete narrowing of ascending aorta. the murmur associated with it is systolic murmur and is similar in character to valvular aortic stenosis murmur but commonly present at 1st intercostal space (ics) on the right. individuals with this anomaly may have unequal carotid pulses, differential blood pressure in upper extremities and a palpable thrill in suprasternal notch. 









































individuals with significant supravalvular as chronically may develop left ventricular hypertrophy and also are at risk of developing coronary artery stenosis.
supravalvular aortic stenosis