USMLE Step 3 - Question 12

A 42 year old male with a history of hypertension has been experiencing dyspnea on exertion. He denies any chest pain. His blood pressure is 140/40, heart rate 90, and  respirations 18. Physical examination reveals elevated jugular venous pressure, an early systolic ejection sound is heard. A III/IV early diastolic decrescendo murmur heard best at the right upper sternal border is present along with a I/IV diastolic rumble at the apex. Also noted is a II/VI systolic ejection murmur at the right upper sternal border. What other physical exam finding might you expect?

A. Pulsus bisferen

B. Pulsus alternans

C. Pulsus paradoxus

D. Pulses parvus et tardus

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