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
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Source: Kevin, M.D. - Medical Weblog - Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/mksap" rel="tag" > mksap < /a > Tags: Conditions Heart Source Type: blogs
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