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The clinician is often confronted with an intense systolic murmur, heard maximally at the base, but also well at the apex. Among the several causes for such a murmur, aortic stenosis is usually an important consideration. Simple tests to assess the presence and severity of aortic stenosis are particularly important, since for definitive evaluation, the relatively difficult and hazardous technique of catheterization of the left side of the heart is required. The phonocardiogram, together with the indirect carotid-pulse tracing, provides a safe means to obtain valuable information about the condition of the aortic valve and surrounding structures.
Stenosis in the aortic region may be confined to the valve or involve the tissues immediately above or below this structure. Moreover, the narrowing may be "fixed," meaning that its caliber remains constant throughout the cardiac cycle, or it may be variable, as in the case of idiopathic hypertrophic subaortic stenosis (muscular subvalvar
Tavel ME. Clinical Phonocardiography: II. Its Use in the Evaluation of Aortic Stenosis. JAMA. 1967;202(12):1093–1094. doi:10.1001/jama.1967.03130250075014
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