What type of heart murmur is associated with aortic stenosis?

The correct answer is associated with aortic stenosis, which typically produces a systolic murmur characterized as a "rough" or "harsh" sound. This murmur is best heard over the second right intercostal space (ICS) due to the turbulent blood flow as it passes through the narrowed aortic valve during systole when the left ventricle contracts.

Aortic stenosis primarily leads to this systolic ejection murmur because the left ventricle must work harder to eject blood through the narrowed opening. As a result, the turbulence created results in that distinctive harsh quality, which can often be described as "crescendo-decrescendo" in nature. The location at the second right ICS aligns with the anatomical position of the aortic valve, providing a clear auscultatory focus for this type of murmur.

This physiological understanding underscores why this option is the most accurate representation of the typical heart murmur associated with aortic stenosis.