A patient with severe aortic stenosis has exertional syncope, angina and LVEF 45%. Coronary disease has been assessed and surgical risk is

Question

A patient with severe aortic stenosis has exertional syncope, angina and LVEF 45%. Coronary disease has been assessed and surgical risk is intermediate. What is the disease-modifying next step?

Accepted Answer

Refer for valve-team aortic-valve replacement planning

Answer

Start long-term nitrates as definitive treatment for the stenosis

Answer

Escalate diuretics alone and reassess echocardiography annually

Answer

Use balloon valvuloplasty as permanent therapy in an operable patient

Answer

Observe because preserved daily function excludes symptomatic severe disease

Reactivation tuberculosis — RCPSC IM MCQ

A patient with severe aortic stenosis has exertional syncope, angina and LVEF 45%. Coronary disease has been assessed and surgical risk is intermediate. What is the disease-modifying next step?