What is a classic auscultatory finding in patients with aortic stenosis?

A harsh, crescendo-decrescendo systolic murmur is characteristic of aortic stenosis. This type of murmur occurs due to the turbulent blood flow generated as blood is ejected through the narrowed aortic valve during systole. The crescendo-decrescendo pattern reflects the increasing intensity of the murmur as the left ventricle contracts and then decreases as the heart's ventricle finishes its ejection phase. This specific sound can be best heard at the second intercostal space, typically in the right sternal border area, and is often accompanied by a diminished or absent second heart sound (S2) due to the stiffened aortic valve.

A diastolic murmur suggests abnormalities of the aortic or mitral valves but is not typically associated with aortic stenosis. A continuous "machinery" murmur is typically heard in patients with patent ductus arteriosus, not aortic stenosis. A high-pitched systolic ejection murmur is more descriptive of other conditions, such as pulmonary stenosis, and does not accurately characterize the classic finding in aortic stenosis. Hence, the identification of the distinctive crescendo-decrescendo quality of the systolic murmur solidifies why this auscultatory finding