Pulmonary valve stenosis is classically associated with which auscultatory finding?

• A. A Click separated from the first heart sound
• B. A wide split S2
• C. A diastolic murmur
• D. A continuous murmur

Answer: (A)

Pulmonary stenosis often produces an ejection phenomenon from the pulmonic valve opening. The telltale sign is an ejection click heard early in systole, separated from the first heart sound, reflecting the sudden opening of a stenotic pulmonic valve. This click is typically followed by a systolic ejection murmur best heard at the left upper sternal border. The other options don’t fit PS: a wide split S2 suggests issues like ASD or RBBB, a diastolic murmur points to regurgitation or different valvular disease, and a continuous murmur is classic for PDA or similar anomalies. The distinct ejection click separated from S1 is the classic association with pulmonary stenosis.