Question

A 58-year-old woman presents with progressive exertional dyspnoea, exertional chest discomfort and presyncope. She has a harsh ejection systolic murmur at the right upper sternal border radiating to the carotids. Echocardiogram shows severe aortic stenosis with valve area 0.7 cm² and reduced exercise tolerance. What is the most appropriate management?

Accepted Answer

Refer for aortic valve replacement or transcatheter aortic valve implantation

Answer

Annual echocardiographic monitoring only

Answer

Start beta blocker and ACE inhibitor without intervention

Answer

Percutaneous balloon valvuloplasty as definitive treatment

Answer

Anticoagulation with warfarin to prevent emboli

Practice question