A 52-year-old man arrives at the office after experiencing progressive fatigue and exertional dyspnea for two weeks. The patient is a postal delivery worker who says he gets out of breath after a few blocks. He has not experienced any chest pain or palpitations. The patient does not smoke, drink alcohol, or use illegal drugs. Cardiac auscultation reveals a murmur, which can be heard best when the patient sits up and leans forward. He brings the report from a recent cardiac catheterization to the office (graph shown below). This patient's murmur would most likely be loudest at which of the following time points on the graph?

Question

Quizplus · Accepted Answer

Eductional Objective: Aortic regurgitation produces a decrescendo diastolic murmur, with maximum intensity just after aortic valve closure, when the pressure gradient between the aorta and left ventricle is greatest. Aortic regurgitation is distinguished by the loss of the aortic dicrotic notch, a steep diastolic decline in aortic pressure, and high-peaking systolic pressures.

A 52-Year-Old Man Arrives at the Office After Experiencing Progressive