Man with blackouts


A man presents with blackouts. His cardiac exam is as follows:

Pulse: Slow rising

First heart sound (s1): normal

Second Heart sound (s2) : normal

Murmur: Ejection systolic and early diastolic rumbling murmur

What is the most likely diagnosis?

  • Aortic Stenosis
  • Aortic Stenosis with Aortic Regurgitation
  • Aortic Stenosis with Mitral Regurgitation
  • Mitral stenosis with mitral regurgitation
  • Aortic Sclerosis

Aortic Stenosis with Aortic Regurgitation

The ESM suggests AS as does the slow rising pulse. BUT! Theres also an early diastolic murmur heard. This is probably AR making the diagnosis of Mixed aortic valve disease.