An 83-year-old has exertional syncope and dyspnea. Echocardiography shows severe calcific aortic stenosis with peak velocity 4.6 m/s, mean gradient

Question

An 83-year-old has exertional syncope and dyspnea. Echocardiography shows severe calcific aortic stenosis with peak velocity 4.6 m/s, mean gradient 52 mm Hg, valve area 0.7 cm2, and LVEF 60%. What is the next management step?

Accepted Answer

Refer for aortic-valve intervention after heart-team assessment

Answer

Start a beta-blocker to delay valve intervention

Answer

Treat symptoms with loop diuretics alone and defer valve evaluation

Answer

Continue observation with annual echocardiography because ejection fraction is preserved

Answer

Perform balloon valvuloplasty as definitive treatment for every symptomatic older adult

Severe aortic stenosis — ABIM Board MCQ

An 83-year-old has exertional syncope and dyspnea. Echocardiography shows severe calcific aortic stenosis with peak velocity 4.6 m/s, mean gradient 52 mm Hg, valve area 0.7 cm2, and LVEF 60%. What is the next management step?