What is the pitch and quality of the murmur heard in aortic stenosis?

In aortic stenosis, the characteristic murmur is typically described as medium-pitched and harsh, which aligns with the hemodynamic changes occurring in this condition. This murmur results from turbulent blood flow across the narrowed aortic valve during systole. The "harsh" quality is indicative of the increased velocity of blood flow through the constricted opening, leading to a distinct sound that can sometimes be accompanied by a thrill—a palpable vibration felt when the murmur is particularly loud and vigorous.

The timing of the murmur is important as well; it typically occurs between the first heart sound (S1) and the second heart sound (S2) during systole, which is a hallmark of aortic stenosis. The presence of a thrill is a significant finding that suggests a more severe degree of stenosis, indicating that the pressure gradient across the aortic valve is substantial enough to create heightened turbulence.

Understanding these features of the murmur in aortic stenosis helps in identifying the condition during a physical exam and differentiating it from other cardiac murmurs that may present in various ways, such as with different pitches or qualities.