Аудіо 00044. Aortic stenosis (bicuspic aortic valve)

This symptomless boy in good condition has a mildly stenotic bicuspid aortic valve and minor aortic regurgitation. ECG and chest radiograph are normal. On echocardiography aortic flow gradient is 10 mmHg, however, colour shows turbulent flow. The regurgitation is haemodynamically insignificant. On auscultation the murmur is a coarser and longer third-degree systolic sound compared with the physiological sound. A first-degree early diastolic regurgitation murmur is also heard occasionally. Phono- and spectrograms also show a murmur that suggests mild stenosis. Age 16.4 years. Area of auscultation: right second ic (RIC2).