A patient with a crescendo/decrescendo systolic murmur and a decreased A2 is likely being evaluated for what condition?

The presence of a crescendo/decrescendo systolic murmur combined with a decreased A2 is characteristic of aortic stenosis. This type of murmur occurs during the left ventricular outflow obstruction, where the sound increases in amplitude (crescendo) as blood is ejected from the ventricle, peaking and then decreasing (decrescendo) as the ejection ends.

In aortic stenosis, the aortic valve does not open fully, leading to turbulent blood flow, which produces the characteristic murmur. The decreased A2, referring to a diminished closure sound of the aortic valve, suggests that the valve is not functioning properly, typically due to thickening or calcification that accompanies aortic stenosis.

Understanding these hemodynamic principles is crucial for recognizing the specific conditions associated with various murmurs and their alterations in heart sounds. Recognizing the distinctive features of aortic stenosis can guide diagnostic and management decisions.