It has been my belief for a long time that most patients with these complaints have these complaints having nothing with the exculpatory or echocardiographic findings. It just means that the murmur is evanescent. It is positional and can be made to come and go by a variety of maneuvers. Aortic stenosis is a common congenital disease. If on the other hand the patient develops Aortic sclerosis is a different entity than aortic stenosis.
Aortic sclerosis is merely a sound.
You hear a systolic murmur but the patient does not have clinical hemodynamic or echocardiographic or invasively defined hemodynamic evidence of left ventricular outflow obstruction. But keep in mind that, as has recently been discovered, this so-called benign systolic ejection murmur may not be as benign as we used to think it is. A dissecting aneurysm, annular-aortic coarctation, syphilis, or other connective tissue disease that might dilate the root. This entity presents as left ventricular overload in which there is a large stroke volume generated by left ventricular dilatation and left ventricular hypertrophy tends to normalize systolic stress. Unfortunately, dilatation is ordinarily accompanied by an elevation of the diastolic stress of the heart.