This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: C.V.S, Subject name: Medicine
Which of the following physical signs is seen in a patient with severe aoic stenosis 
Select and explain. 
A. Opening snap, B. Diastolic rumble, C. Holosystolic murmur, D. Delayed peak of systolic murmur
D: Delayed peak of systolic murmur
Answer: D: Delayed peak of systolic murmur 
Explanation: The murmur of AS is characteristically an ejection (mid) systolic murmur that commences sholy after the S 1 , increases in intensity to reach a peak toward the middle of ejection, and ends just before aoic valve closure . It is characteristically low-pitched, rough and rasping in character, and loudest at the base of the hea, most commonly in the second right intercostal space. It is transmitted upward along the carotid aeries. Occasionally it is transmitted downward and to the apex, where it may be confused with the systolic murmur of MR (Gallavardin effect). ( Harrison&;s principle of internal medicine,18th edition,pg no.1939 )