A loud murmur heard at the base of the heart which radiates to the sternal notch and the carotid arteries is most likely produced by the:

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A murmur heard at the base of the heart which radiates superiorly is most likely an aortic murmur, indicative of disease in the valve that separates the left ventricle from the aorta. Murmurs result from turbulent flow through valves and are often caused by irregularities in the endothelium of valves, or disruptions in normal valve functioning. They may be heard in systole or diastole.

A Loud Murmur Heard at the Base of the Heart