Carotid artery pulse tracing and phonocardiogram of aortic stenosis with bicuspid aortic stenosis

Carotid artery pulse tracing and phonocardiogram of aortic stenosis as heard at the apex. S1 (mitral and tricuspid valve closure) is followed by an ejection click from the opening of the stenotic aortic valve. A faint midsystolic murmur of aortic stenosis is heard. S2 is single as a result of delayed aortic valve closure, which occurs simultaneously with closure of the pulmonic valve.