A 79-year-old man has exertional dyspnea and near-syncope. Examination shows a late-peaking systolic murmur at the right upper sternal border

Question

A 79-year-old man has exertional dyspnea and near-syncope. Examination shows a late-peaking systolic murmur at the right upper sternal border radiating to the carotids and delayed carotid upstroke. Echocardiogram shows valve area 0.8 cm2. Which of the following is the most appropriate at this time?

Accepted Answer

Refer for aortic valve replacement evaluation

Answer

Start high-intensity exercise training without evaluation

Answer

Schedule routine follow-up in 5 years

Answer

Use thrombolysis

Answer

Treat with antibiotics alone

Aortic stenosis — USMLE Step 3 MCQ

A 79-year-old man has exertional dyspnea and near-syncope. Examination shows a late-peaking systolic murmur at the right upper sternal border radiating to the carotids and delayed carotid upstroke. Echocardiogram shows valve area 0.8 cm2. Which of the following is the most appropriate at this time?