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What is A 68-year old man who has had a recent syncopal Episode is hospitalized with congestive hea failure failure. His blood pressure is 160/80 mm Hg. His pulse rate is 80 Beats minute,and there is agrade lll/lV harsh systolic murmur. and explain in detail?
Carotid upstroke. A delayed upstroke (pulsus parvus et tardus) can suggest aoic stenosis, left ventricular outflow obstruction, or significant decrease in stroke volume. Vascular stiffness due to aging can reduce the delay, causing a more normal-feeling upstroke Ref Davidson 23rd edition pg 456