MKSAP: 47-year-old man with a bicuspid aortic valve

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 47-year-old man is evaluated during a routine examination. He has no symptoms. Medical history is significant for a bicuspid aortic valve. He is not taking any medications. On physical examination, he is afebrile, blood pressure is 130/70 mm Hg, pulse rate is 56/min, and respiration rate is 15/min. Cardiac examination reveals a grade 1/6 diastolic murmur at the left lower sternal border. Echocardiogram shows a bicuspid aortic valve with moderate aortic regurgitation, normal left ventricular systolic function, and normal left ventricular chamber size. Which of the following is the most appropriate management? A: Aortic valve replacement B: Clinical reassessment in 1 year C: Endocarditis prophylaxis D: Start an ACE inhibitor E: Start a calcium channel blocker Continue reading ... Your patients are rating you online: How to respond. Manage your online reputation: A social media guide. Find out how.
Source: Kevin, M.D. - Medical Weblog - Category: Journals (General) Authors: Tags: Conditions Heart Source Type: blogs