Which of the following physical signs is seen in a patient with severe aoic stenosis:
Opening snap
Diastolic rumble
Holosystolic murmur
Delayed peak of systolic murmur
Answer is D (Delayed peak of systolic murmur) The ejection systolic murmur stas after the ejection click reaches a peak in midsystole. With increasing severity of aoic stenosis the peak gets delayed so that the maximum intensity of the murmur is closer to the end rather than being midsystolic.