Systolic murmur radiating to the carotids = aortic stenosis.

Squatting increases SVR and venous return, thereby increasing the intensity of aortic stenosis, mitral stenosis, aortic regurgitation, and mitral regurgitation. Murmurs due to hypertrophic obstructive cardiomyopathy and mitral valve prolapse are decreased.

Rheumatic fever most commonly affects the mitral valve, but aortic comes in second place. Aortic stenosis is also common in the elderly due to senile calcification.

This guy needs an echo to characterize severity.