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A patient presenting with aortic stenosis would have a murmur that is usually heard at the right second and third intercostal spaces, is loud with a thrill, the pitch is medium and harsh, and can have a quality that is musical at the apex (Bickley, 2017).
Larsson et al. (2017) lists different causes of aortic stenosis. High body mass index (BMI), hypertension, increased low-density lipoprotein (LDL) cholesterol levels, dyslipidemia, and cigarette smoking are all associated with development of aortic stenosis. For TY, her history of smoking cigarettes, hypertension, and hyperlipidemia can all contribute to her aortic stenosis diagnosis.
Bickley (2017) explains different causes of heart murmurs. Innocent heart murmurs occur without any physiologic or structural abnormality. Innocent murmurs occur from blood circulating normally through the heart’s chambers and valves or through blood vessels near the heart. Hypertrophic cardiomyopathy and pulmonic stenosis are other causes of pathologic heart murmurs aside from aortic stenosis.
Subaortic stenosis is classified as a congenital heart disease and it is related to the obstruction of the left ventricular outflow tract (Xiao et al., 2018). It occurs when the flow of blood from the heart’s pumping chamber or left ventricle is restricted. Subaortic stenosis can cause a mitral diastolic murmur (Bickley, 2017).
References
Bickley, L. S. (2017). Bates’ Guide to Physical Examination and History Taking (12th ed.). Lippincott Williams & Wilkins.
Larsson, S. C., Wolk, A., Bäck, M., & Bäck, M. (2017). Alcohol consumption, cigarette smoking and incidence of aortic valve stenosis. Journal of Internal Medicine, 282(4), 332–339. https://doi-org./10.1111/joim.12630
Xiao, dong, L., Xin, yao, L., Hui, X., Xiao, cong, W., Xiao-Dong, L., Xin-Yao, L., & Xiao-Cong, W. (2018). Membranous subaortic stenosis coexisting with hypertrophic cardiomyopathy: A case report. Journal of Clinical Ultrasound, 46(9), 610–613. https://doi-org./10.1002/jcu.22613
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