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In the editorial by Alpert,¹ the first aortic stenosis murmur the author heard was not aortic stenosis; it was a regurgitant murmur if it indeed was "obliterating the second heart sound." I suspect that if the diagnosis was in fact aortic stenosis, then the second heart sound (A2) was merely absent.

Kenneth V. Robb, MD, FRCP
Toronto, Ontario

1. Alpert JS. Aortic stenosis: a new face for an old disease. Arch Intern Med. 2003;163:1769-1770. FREE FULL TEXT

Arch Intern Med. 2004;164:108.

RELATED ARTICLE

Aortic Stenosis: A New Face for an Old Disease
Joseph S. Alpert
Arch Intern Med. 2003;163(15):1769-1770.
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