Aortic stenosis: The Daily PANCE Blueprint

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Aortic stenosis: The Daily PANCE Blueprint

A 65-year-old male with a history of hypertension and hyperlipidemia presents with fatigue and exertional dyspnea. On physical examination, a harsh crescendo-decrescendo systolic murmur is noted at the right upper sternal border, radiating to the carotids. His blood pressure is 135/85 mmHg, and his pulse is delayed and diminished. Which of the following best describes the effect of aortic stenosis on pulse pressure?

A. Narrow pulse pressure
B. Wide pulse pressure
C. Normal pulse pressure
D. Pulse pressure increases during systole only
E. Pulse pressure fluctuates with respiratory variation

Answer and topic summary

The answer is A. Narrow pulse pressure

In aortic stenosis, the narrowing of the aortic valve impairs the ejection of blood from the left ventricle during systole, leading to a reduced stroke volume. This results in a lower systolic pressure relative to diastolic pressure, creating a narrow pulse pressure (the difference between systolic and diastolic blood pressure). Additionally, aortic stenosis is associated with a delayed and weakened pulse, also known as pulsus parvus et tardus, which reflects the obstructive outflow. A narrow pulse pressure is a hallmark finding in severe aortic stenosis.

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Covered under ⇒ PANCE Blueprint Cardiology ⇒ Valvular Disorders ⇒ Aortic stenosis

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