Royal Australian College of General Practitioners (RACGP) Practice Exam

The aortic stenosis murmur is best auscultated at the right of the sternum, specifically in the second intercostal space. This location corresponds to the area where the aortic valve is situated in relation to the chest wall. When the aortic valve becomes narrowed, the turbulent blood flow from the left ventricle into the aorta produces a characteristic systolic ejection murmur, which is best heard in this position.

Auscultation at this site allows optimal transmission of the sound generated by the left ventricular outflow tract and the resulting turbulence as blood flows through the narrowed valve. This characteristic sound typically has a "crescendo-decrescendo" shape and is best observed during systole.

In contrast, other locations mentioned are not optimal for auscultating the murmur of aortic stenosis. The left sternal border or the apex may be associated with different heart sounds or murmurs, while the left axilla might be involved in assessing regurgitant flow rather than the stenotic sound. Thus, knowing the auscultation points is crucial for accurate diagnosis in relation to heart conditions such as aortic stenosis.