Walls Within Walls: A Tale of Twin Aortic Stenosis in Type II Familial Hypercholesterolemia

A teenage boy presented with multiple episodes of exertional syncope over the previous 3 months. Clinical examination revealed pulsus parvus et tardus and a late-peaking, ejection systolic, crescendo-decrescendo murmur in the aortic area with radiation to the carotids.