After auscultating the aortic area,you determine that a patient has a diminished A₂ and an ejection click.The most likely cause of these two findings is

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The second heart sound (S₂)is associated with the closure of the semilunar valves.You can hear it with the diaphragm on the aortic landmark.The components of S₂ are A₂ (aortic)and P₂ (pulmonic).A greatly intensified or diminished A₂ is considered abnormal.A diminished A₂ can be caused by aortic stenosis where the aortic valve is calcified or thickened.The ejection click occurs early in systole at the start of ejection because it results from the opening of the semilunar valves.Normally,the semilunar valves open silently,but in the presence of aortic stenosis their openings make a sound.It is short and high pitched,with a click quality.A greatly intensified A₂ can be the result of arterial hypertension that increases the pressure in the aorta.

After Auscultating the Aortic Area,you Determine That a Patient Has