José Maria Gonçalves Fernandes, Flávio Bonaparte Laranjeira, Margareth de Souza Lira Handro, Benício de Oliveira Romão, Francisco de Assis Costa, Ivan Romero Rivera, Maria Alayde Mendonça Rivera
A systolic murmur best heard at the aortic area with radiation to the neck is considered a hallmark of aortic stenosis. We report a patient with this auscultatory pattern in whom investigation revealed an unexpected diagnosis. Accompanying symptoms reinforced the initial suspicion, adding another layer of complexity to the diagnostic process. This case highlights the limitations of relying solely on symptom profile and murmur topography, and underscores the importance of comprehensive physical examination and diagnostic imaging in evaluating valvular heart disease.