A 72-year-old woman with a systolic ejection murmur most likely suggests which condition?

• A. Mitral regurgitation
• B. Aortic stenosis
• C. Tricuspid regurgitation
• D. Pulmonary hypertension

Answer: (B)

A systolic ejection murmur is most commonly associated with aortic stenosis, particularly in older adults. This condition occurs when the aortic valve becomes narrowed, making it difficult for blood to flow from the heart's left ventricle into the aorta during systole (the heart's contraction phase).

In aortic stenosis, the murmur is typically described as a "crescendo-decrescendo" pattern, meaning it increases in intensity and then decreases. This type of sound is a hallmark of the turbulence created by blood flowing through the narrowed valve. Additionally, in older patients, aortic stenosis is often due to age-related calcific degeneration of the valve, rather than being congenital.

The other conditions listed can also produce murmurs, but they typically manifest differently. Mitral regurgitation, for instance, usually results in a holosystolic murmur that is best heard at the apex and may radiate to the left axilla. Tricuspid regurgitation commonly results in a holosystolic murmur as well, with the sound best heard near the lower left sternal border. Pulmonary hypertension may cause a variety of heart sounds but is not specifically associated with a systolic ejection murmur