Bottleneck
A 68 year old man is referred for evaluation of a heart murmur discovered at a routine checkup.
Initially, he claims to be asymptomatic. However, further questioning reveals a slight decrease in exercise capacity which he attributes to "old age".
His medical and drug histories are unremarkable.
Initially, he claims to be asymptomatic. However, further questioning reveals a slight decrease in exercise capacity which he attributes to "old age".
His medical and drug histories are unremarkable.
Select Relevant Investigations
ECG
Performed
The ECG appears normal.
Chest X ray
Performed
The x-ray appears normal.
Echocardiography
Performed
There is moderate aortic stenosis with an increased transvalvular pressure gradient and decreased transaortic flow velocity. Left ventricular hypertrophy is noted, while the ejection fraction is 60%.
Coronary Angiography
Performed
Coronary angiography shows a pristine coronary vasculature, with a right dominant circulation.
Select Relevant Management
Statins
Aspirin
Aortic Valve Replacement
Endocarditis Prophylaxis
