You are incorrect - the most likely diagnosis in our patient is hypertrophic obstructive cardiomyopathy.


Your choice: Severe valvular aortic stenosis

Patients with severe valvular aortic stenosis may present with distinct bedside findings. These include a narrow pulse pressure, a slow rising hypokinetic arterial pulse, a sustained apical impulse with a presystolic component and a murmur and ejection sound heard best at the upper right sternal edge, due to the location of the lesion.