Exertional chest discomfort
by Franklin B Saksena, Ranganathan Narasimhan, Sivaciyan Vahe

The Art and Science of Cardiac Physical Examination (With Heart Sounds, Jugular and Precordial Pulsations)

by Narasimhan Ranganathan, Vahe Sivaciyan, Franklin B Saksena
About Video

This recording is taken from the apex area of a 65 years old man presenting with symptoms of exertional chest discomfort. He had a rapid carotid pulse upstroke, a sustained left ventricular apical impulse with an intermittent atrial kick. At the apex he had a systolic murmur. This recording is made in the supine position. The systolic murmur is harsh and mid systolic and ejection in quality. In this recording there also appears to be a soft S2 (softer than the murmur and yet the S2 is audible, indicating that the murmur ends before the S2). This of course is highly suggestive of an ejection murmur.

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