Visible pulsus parvus et tardus in patient of aortic stenosis

Description

A 35-year-old male presenting with 1-year history of shortness of breath and angina on exertion. On examination, he was noted to have pulsatile neck vessels and ejection systolic murmur as shown in video 1. Possibilities kept for pulsatile neck vessels were aortic regurgitation (AR; dancing carotid), tricuspid regurgitation (TR; c-v waves), third-degree heart block (canon a wave) and thoracic aortic aneurysm. Two-dimensional (2D) echocardiography was done which ruled out any AR, TR lesions and showed presence of severe aortic stenosis in four-chamber view video 2 with severity confirmed in Doppler parasternal long-axis view video 3.

Video 1

Showing regularly pulsating neck vessels with highest impact in suprasternal notch and radiating to lateral as well as superior aspect.

Video 2

Apical five-chamber view showing dilated and hypertrophied left ventricular cavity and dilated left atrial cavity, also showing thickened and calcified...

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